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# Mometrix ## Complications Of Chronic Renal Failure - **Platelet Abnormalities:** Decreased platelet count, increased turnover, and reduced adhesion lead to bleeding disorders. - **Metabolic Acidosis:** The tubular cells are unable to regulate acid-base metabolism, and phosphate, sulfuric, hippu...

# Mometrix ## Complications Of Chronic Renal Failure - **Platelet Abnormalities:** Decreased platelet count, increased turnover, and reduced adhesion lead to bleeding disorders. - **Metabolic Acidosis:** The tubular cells are unable to regulate acid-base metabolism, and phosphate, sulfuric, hippuric, and lactic acids increase, leading to congestive heart failure and weakness. - **Hyperkalemia** The nephrons cannot excrete adequate amounts of potassium. Some drugs, such as diuretics that spare potassium may aggravate the condition. - **Renal Bone Disease:** Decreased calcium, increased phosphate and para-thyroid hormone, decreased utilization of vitamin D lead to demineralization. In some cases, calcium and phosphate are deposited in other tissues (metastatic calcification). - **Multiple Endocrine Disorders:** Thyroid hormone production is decreased and re-productive hormones abnormalities may result in infertility/impotence. Males have decreased testosterone but increased estrogen and LH. Females experience irregular cycles, lack of ovulation and menses. Insulin production may increase but with decreased clearance, resulting in episodes of hypoglycemia or decreased hyperglycemia in those who are diabetic. - **Cardiovascular Disorders:** Left ventricular hypertrophy is most common, but fluid retention may cause congestive heart failure and electrolyte imbalances, dysrhythmias. Pericarditis, exacerbation of valvular disorders, and pericardial effusions may occur. - **Anorexia, Malnutrition:** Nausea and poor appetite contribute to hypoalbuminemia, sometimes exacerbated by restrictive diets. ## Renal Dialysis Renal dialysis is used primarily for those who have progressed from renal insufficiency to uremia with end stage renal disease (ESRD). It may also be temporarily for acute conditions. Children can be maintained on dialysis, but there are many complications associated with dialysis; so many children are considered for renal transplantation. There are a number of different approaches to dialysis: ### Types of Dialysis - **Peritoneal Dialysis:** An indwelling catheter is inserted surgically into the peritoneal cavity with a subcutaneous tunnel and a Dacron cuff to prevent infection. Sterile dialysate solution is slowly instilled through gravity, remains for a prescribed length of time, and is then drained and discarded. Peritoneal dialysis may be used for those who want to be more independent, don't live near a dialysis center, or want fewer dietary restrictions - **Continuous Ambulatory Peritoneal Dialysis:** A series of exchange cycles are repeated 24 hours a day - **Continuous Cyclic Peritoneal Dialysis:** A prolonged period of retaining fluid occurs during the day with drainage at night ## Hemodialysis Hemodialysis, the most common type of dialysis, is used for both short-term dialysis and long-term for those with ESRD. Treatments are usually done 3 times weekly for 3–4 hours or short daily dialysis with treatment either during the night or in short daily periods. Hemodialysis is often done for those who can't manage peritoneal dialysis or who live near a dialysis center, but it does interfere with work or school attendance and requires strict dietary and fluid restrictions between treatments. Short daily dialysis allows more independence, and increased costs may be offset by lower morbidity. A vascular access device, such as a catheter, fistula, or graft must be established for hemodialysis, and heparin is used to prevent clotting. With hemodialysis, blood is circulated outside of the body through a dialyzer (a synthetic semipermeable membrane), which filters the blood.