renal replacement tx Flashcards
indications for renal replacement tx
Acidosis, Electrolytes, Ingestions, Overload, Uremia
what is the concept of clearance
the volume of plasma cleared completely of a given substance per unit time
how to create osmotic gradient in peritoneal dialysis soln?
glu in various concentratiosn
main complication assc’d with peritoneal dialysis
peritonitis
2 most common causes of death in patients on dialysis
- CV
2. infections
what is the preferred method of renal replacement tx
kidney transplantation
where do most deceased donor organs come from?
brain dead donors
relative contraindication for kidney transplant recipient: estimated life span under
5 yrs
induction phase immunosuppr meds (3)
- corticosteroids
- anti-thympcyte globulin
- IL-2 receptor antags
what are the calcineurin inhibs (2)
- cyclosporine
2. tacrolimus
immunosuppressive regimen of choice
- tacrolimus
- mycophenolate
- prednisone
thrombosis of donor renal artery or vein, occurs in 1st week, dx with U/S with doppler
graft thrombosis
elevated Cr, abd pain, Dx with nuclear medicine scan
urine leak
what does hyperacute rejection lead to?
immediate graft loss
some possibilities to remedy hyperacute rejection
- plasmapharesis
2. pulse steroid
tx for chronic allograft rejection
none
leading cause of death in patients receiving transplants
infections
what virus lives latently in GU tract and is eactivated by immunsuppre
BV virus
most common malignancy assc’d wtih post-transplant patients
skin cancer
agent of choice for tx’ing new onset HTN in post transplant patients
CCB (nifedipine, amlodipine, isradapine)
