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Renal Week 3 2017/18 > 3: Dialysis > Flashcards

Flashcards in 3: Dialysis Deck (27)
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1

Which three process are involved in dialysis?

Diffusion

Convection

Adsorbption

2

What builds up in end stage kidney disease and needs to be removed by dialysis?

Toxins

urea, sodium, potassium

3

How is metabolic acidosis associated with end stage kidney disease corrected?

Sodium bicarbonate

4

What passes from the dialyte to the blood by diffusion to correct metabolic acidosis?

Sodium bicarbonate

5

Why does end stage kidney disease cause metabolic acidosis?

Kidneys can't filter H+

6

How is the movement of water controlled in dialysis?

Convection / ultrafiltration

controlled by altering the pressure rather than the conc. gradients of electrolytes

7

How is the transport of plasma proteins controlled in dialysis?

Size of the pores in the dialyser

by absorption

8

Which processes control

a) electrolyte

b) water

c) plasma protein

transport in dialysis?

a) Diffusion (solute gradients)

b) Convection / ultrafiltration (pressure gradient)

c) Absorption (size of the pores)

9

How long do patients tend to be on haemodialysis for per week?

4 hours

3 times a week

minimum

10

What lifestyle restrictions are put on patients on dialysis?

Fluid restriction

Salt restriction

11

Which electrolyte imbalances are people with CKD at risk of?

Hypernatraemia (> fluid overload)

Hyperkalaemia (>arrythmia)

Hyperphosphataemia (bone disease)

so they're all restricted

12

How is a patient hooked up to haemodialysis?

Fistula

artery and vein joined together (e.g radial artery & bacilic vein)

13

What are complications of using a fistula for dialysis?

Stenosis

Thrombosis

regularly reviewed

14

Fistulas are (planned / emergency) procedures for people with CKD.

planned operation

no good in emergency presentations

15

How is dialysis given to patients with emergency presentations of CKD / renal failure?

Tunneled venous catheter

internal jugular or femoral vein

16

What is a complication of using a tunneled venous catheter for dialysis?

Infection

17

Which organism usually causes infections associated with tunneled venous catheters?

Staph aureus

18

Which antibiotics are given for dialysis line infections?

IV vancomycin

19

Apart from infection, what are possible complications of dialysis?

Hypotension - decrease in blood volume due to filtration

Haemorrhage from ruptured fistula

 

20

How does peritoneal dialysis work?

Peritoneum has loads of capillaries

Fluid into peritoneal cavity, comes into close contact with capillaries

21

How are

a) solutes

b) water

removed from the blood by peritoneal dialysis?

a) Diffusion (high > low)

b) Osmosis (dialysate has high glucose conc.)

22

Why is glucose included in the dialyte in peritoneal dialysis?

Increases the osmolarity of the dialyte, encouraging osmosis FROM the peritoneal capillaries

The peritoneal capillaries contain glucose themselves and so have their own osmolarity which needs to be overcome

23

How often are patients given continuous (bags) peritoneal dialysis for?

How long does each session take?

QDS

20-30 mins

24

What types of peritoneal dialysis are given

a) throughout the day

b) at night?

a) Continuous

b) Automated

25

Which bacteria can cause infection in patients on peritoneal dialysis?

Skin commensals (staph, strep)

Gut commensals (E. coli, klebsiella)

26

What are GI complications of peritoneal dialysis?

Hernia

Peritonitis

27

What are common causes of death in people on dialysis?

CVD - MI, stroke

Infection