Peritoneal Dialysis and Hemodialysis PDF

Erythropoietin Uremia - Occurs when waste products associated with decreased kidney function build up in the blood - “Urine in the blood” - Symptoms: cognitive dysfunction, fatigue, SOB from fluid accumulation, loss of appetite, muscle cramps, nausea and vomiting, itching, un...

Erythropoietin Uremia - Occurs when waste products associated with decreased kidney function build up in the blood - “Urine in the blood” - Symptoms: cognitive dysfunction, fatigue, SOB from fluid accumulation, loss of appetite, muscle cramps, nausea and vomiting, itching, unexplained weight loss - Uremic fetor d/t accumulation of ammonia - Uremic frost (crystalized sweat) Kidney functions: “A WET BED” A - cid-base balance W - ater balance E - electrolyte balance T - oxin removal B - lood pressure control E - rythropoietin D - Vitamin D metabolism Stages of Chronic Kidney Disease Stages 1 - Normal pero below normal ang GFR Stage 2 - Mild loss of kidney function - GFR - 89% to 60% Stage 3a - Mild to moderate kidney function loss - Gfr 59% to 45% Stage 3b - Moderate to severe kidney function loss - 44% to 30% Stage 4 - Severe loss of kidney function - GFR 29% to 15% Stage 5 - Kidney failure  - GFR is lower than 15% Dialysis - procedure used to provide an artificial replacement for lost kidney function d/t renal failure - RRT or renal replacement therapy (renal dialyzer) - four main types of RRT in common use: hemodialysis (HD), peritoneal dialysis (PD) hemofiltration (HF) hemodiafiltration (HDF) Principles of Hemodialysis Diffusion - movement from higher concentration (blood) to lower concentration (dialysate). - toxins and wastes in the blood are removed - if done mabilis, pwede mag-hypotensive or mag-shock - takes 4 to 6 hours Osmosis - excess water is removed from the blood by osmosis - water moves from an area of higher solute concentration (blood) to an area of lower solute concentration (dialysate bath) Ultrafiltration - water moving under high pressure to an area of lower pressure - by a suctioning force → dialysis membrane Indications for dialysis include For patients with ACUTE kidney injury: 1. Metabolic acidosis - where correction with Sodium Bicarb is impractical or may result in fluid overload 2. Electrolyte abnormality - hyperkalemia (↑ K in blood) + AKI 3. Fluid overload that is not expected to respond to diuretics 4. Intoxication: acute poisoning w/ a dialysable drug (lithium, aspirin) 5. Complications of uremia: pericarditis (inflammation of the sac that contains the heart), encephalopathy (group of conditions that cause brain dysfunction) CHRONIC: 1. Symptomatic renal failure 2. Low GFR (glomerular filtration rate)