Flashcards in Dialysis Deck (20)
Minimum time spent on dialysis
4 hours, three times a week
Diet restrictions put on patient
If anuric 1litre per day (including food based fluid)
Low salt diet to reduce thirst and help with fluid balance
Low potassium diet.
Banana's, chocolate, Potatoes, Avocado
Low phosphate diet
Phosphate binders with meals (6-12 pills per day)
Gold standard of dialysis access
What is a fistula?
Joins an artery and a vein to make an enlarged thick walled vein called an ateriovenous fistula
Pros of fistula
Good blood flow
Unlikely to cause infection
Cons of fistula
Required maturation of about 6 weeks before can be used
Can limit blood flow to distal arm "steal"
What is a tunneled venous catheter?
A catheter inserted into a large vein -jugular, subclavian or femoral
Pros of a tunneled catheter
Easy to insert
Can be used straight away
Cons of a tunneled venous catheter
High risk of infection
Can cause damage to veins making placing replacements difficult
Antibiotics if tunneled venous catheter gets infected
You may need to consider line removal or exhange
What happens if you leave an infected tuneled venous catheter untreated
Continuous peritoneal dialysis
4 Bag exchanges per day
Fluid drained then fresh fluid instilled
½ Hour per exchange
Automated peritoneal dialysis
1 Bag of fluid stays in all day
Overnight machine drains in and out fluid for 9-10 hours per night
In peritoneal dialysis, if the membrane fails and not enough water is removed, the body can become fluid overloaded. What do you have to do?
Switch to haemodialysis
Why is there an increased chance of hernias with peritoneal dialysis?
Increased intra-abdominal pressure
-This requires hernia repair and smaller fill volumes
Bone mineral metabolism in ESKD?
Low 1-25 Vit D
Why anaemia in ESKD?
Metabolic complications in ESKD
Bone mineral metabolism
Sodium and water retention
Accelerated CV disease
What medical reasons may force you to stop dialysis?