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Flashcards in Dialysis Deck (20)
1

Minimum time spent on dialysis

4 hours, three times a week

2

Diet restrictions put on patient

Fluid
If anuric 1litre per day (including food based fluid)

Salt
Low salt diet to reduce thirst and help with fluid balance

Potassium
Low potassium diet.
Banana's, chocolate, Potatoes, Avocado

Phosphate
Low phosphate diet
Phosphate binders with meals (6-12 pills per day)

3

Gold standard of dialysis access

Fistula

4

What is a fistula?

Joins an artery and a vein to make an enlarged thick walled vein called an ateriovenous fistula

5

Pros of fistula

Good blood flow
Unlikely to cause infection

6

Cons of fistula

Requires surgery

Required maturation of about 6 weeks before can be used

Can limit blood flow to distal arm "steal"

Can block

7

What is a tunneled venous catheter?

A catheter inserted into a large vein -jugular, subclavian or femoral

8

Pros of a tunneled catheter

Easy to insert
Can be used straight away

9

Cons of a tunneled venous catheter

High risk of infection
Can cause damage to veins making placing replacements difficult
Become blocked

10

Antibiotics if tunneled venous catheter gets infected

Vancomycin

You may need to consider line removal or exhange

11

What happens if you leave an infected tuneled venous catheter untreated

Endocarditis
Discitis
Death

12

CAPD

Continuous peritoneal dialysis

4 Bag exchanges per day
Fluid drained then fresh fluid instilled
½ Hour per exchange

13

APD

Automated peritoneal dialysis

1 Bag of fluid stays in all day
Overnight machine drains in and out fluid for 9-10 hours per night

14

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

15

Why is there an increased chance of hernias with peritoneal dialysis?

Increased intra-abdominal pressure

-This requires hernia repair and smaller fill volumes

16

Bone mineral metabolism in ESKD?

Phosphate retention
Low 1-25 Vit D
Hypocalcaemia
Raised PTH

17

Why anaemia in ESKD?

Epo deficiency
Iron deficiency

18

Metabolic complications in ESKD

Bone mineral metabolism
Anaemia
Sodium and water retention
Accelerated CV disease

19

What medical reasons may force you to stop dialysis?

PVD
Cerebrovascular disease
Cancer

20

Renal bone disease summary

Hypocalcemia means more PTH is produced

This causes calcium from bones to enter blood etc

This leads to vascular calcification

(I think this just keeps going, i.e. no loss of inhibition)