RRT Flashcards
WHAT ARE THE ACHIEVED EFFECTS OF DIALYSIS
Remove nitrogenous substances
Remove water
Rebalance electrolytes: Na+, K+, Mg2+, Ca2+
Increase bicarbonate in blood to balance metabolic acidosis
types of dialysis
hemodialysis - opposite direction
hemofilitartion - same direction , less efficient but better in critically ill patients often done in ICU . patients who cannot tolerate rapid changes in haemodynamic parameter
what is dry weight
Your normal weight without any extra fluid in your body is called “dry weight.”so in dialysis you need to find the perfect balance, you don’t want to remove TOO MUCH fluid or nOT enough
how do you know I you at at normal dry weight
Your blood pressure may be within your normal range after dialysis or before your next session.
You do not experience lightheadedness or cramping between dialysis sessions.
You do not have swelling in your legs, feet, arms, hands, or around your eyes.
Your breathing is comfortable and easy.
How do I maintain dry weight after dialysis?
watch the foods you eat, come up with a meal plan with your speiclaitsl, avoid salty food 1.makes u thirsty 2. drawns in water
limit your fluid intake
keep track of daily weight
what to do in emergency dialysis and not time for fistula risks
go in for central line
or a tunnel line
infection
disadvantages of hemoldilays
CVS complications!!!
Fistula complications: stenosis, aneurysm, infection, steal syndrome, heart failure
disequilibrium sydrome ( acute cereal edema due to abrupt removal of substances ) steel syndrome - blood diverted from extremities
myloidosis (secondary to build up of B2 microglobulin)!
thrombosis and stenosis
sepsis
internal bleeding due to anticoagulants
which type of dialysis is more effective
hemodilayss
advantages of peritoneal dialysis
better flexibility
more easier quality of life
less expensive
PD does reuquire some diet restrictions and fluid but not as much as hemoldilays
disadvanaages of peritoneal
abdomina infections - the diaysite fluid comes out cloudy - peritonitis! typically caused by s. epidermis
Loss of membrane function over time
Encapsulating peritoneal sclerosis: scarring & transport across peritoneal membrane.In rare cases, your peritoneum may gradually become thickened and scarred. Some people may need to switch to haemodialysis after a few years to stop this happenin
does need to be carried out every day
physical effect of having a catheter there (self esteem)
obesity
Another drawback of peritoneal dialysis is that the dialysis fluid used can cause a reduction in protein levels, which can lead to a lack of energy and, in some cases, malnutrition.
constipation can squash the tube or make it move out of place!
indications for dialysis
hyeprkalmeiai metabolic acids electrolytes? uremic complactions hypervolume overload BLAST ME TOXICITY
most common reason for dying on dialysis
cardiac problems - hypertension, electrolyte shifts
why does renal bone disease occur
its often secondary to kidney dysfunction . patients have decreased active vitamin D ( CALCITRIOL) so less ca absorbed from diet.
on top of this hyperphosphatemia due to kidney dysfunction . phosphate loves to bind to calcium in the blood so both of this results in low serum calcium level
due to the hypocalcemia, you get secondary hyperparathyroidism. osteoclast come into action, removing calcium from bones making them more brittle
diagnosis labs of renal osteodrystophy
hypocalcemia
hyperphospahtemia
high levels of pTH
TX OF renal osteodrystrophy
dietary phosphate restriction - meat , cheese, beer, milk , chocolate
vit d supplement
cINACALCET - reduces the levels of pTH . Ibn very rare cases if this doesn’t work can be offered a parathyroidectomy
