updated renal replacement therapy Flashcards
what does RRT mean ?
either kidney transplantation or dialysis
what are the types of access associated with hemodialysis ?
1- arterio-venous fistula
2- arterio-venous graft
3- venous catheter
what are the complications associated with HD vascular access ?
thrombosis
infection
what arre the two types of hemodialysis ?
conventional intermittent HD
continous renal replacement therapy
when do we use IHD ?
in patients with chronic or acute kidney disease who are hemodynamically stable
when do we use CRRT ?
critically ill patients with acute kidney injury who are haemodynamically unstable
what are the indications to the initiation of dialysis ?
fluid overload
electrolyte imbalance
metabolic acidosis
signs of uremia
deterioration of nutritional status refractory to intervention
when do we use HD and when do we use PD ?
in chronic kidney disease we can use either IHD or PD
in acute kidney disease we can use CRRT or IHD
what are the absolute contraindications to dialysis ?
contraindications to hemodialysis - no vascular acccess
peritoneal dialysis -
1-peritoneal adhesion due to previous surgery
2- surgically uncorrectable abdominal hernia
3- abdominal wall stoma
4- diaphragmatic fluid leak
5- inability to perform exchanges
where is the kidney transplanted into ?
iliac fossa of the receiver
when is renal transplantation the treatment of choice ?
in cases of ESRD (CKD)
what is pre emptive rnal transplantatiion n?
performing a renal transplant before reaching ESRD
when the GFR is <20 , perform transplantation
what are the absolute contraindications to renal transplantation ?
1- active sepsis
2- current uncontrolled malignancy
3- uncontrolled psychosis
4- active drug dependence
5- any medical condition with a shortened life expectancy
6- recipient is not compatible immunologically with the donor
what is the algorithm for RRT in cases of CKD ?
the idea is to perform renal transplantation unless there are any contraindications
iff there are then perform PD or IHD
