Dialyzers are where dialysis, the blood purification takes place. This article will address: Dialyzer Components Types of Dialysis Membranes Sterilization Techniques Dialyzer Reactions Dialyzer Components Dialyzers are composed of an outer capsule or shell in which the membranes are located. Capsule / Shell There are 2 components to the capsule/ shell in which
Continuous Renal Replacement Therapy (CRRT). Slow dialysis for critically ill hemodynamically unstable patients. The main benefit of CRRT is that it is better at treating and preventing volume overload in these patients. The main benefit of CRRT. Volume management. It allows for ultrafiltration at a slower rate. How do we decide on ultrafiltration
Continuous Renal Replacement Therapy (CRRT) is a form of slow dialysis for critically ill hemodynamically unstable patients. Why is it used? CRRT has NOT been shown to be associated with improved outcomes (mortality or renal recovery) then intermittent hemodialysis. CRRT is considered to be better tolerated than intermittent hemodialysis hemodynamically unstable patients. CRRT
Talking to patients and families regarding initiation of dialysis can be complex. Typically shared decision making is recommended. This involves more than simply asking if the patient “wants” dialysis. There are two settings where this counseling is necessary. Each has different questions and concerns. The first is a patient with chronic kidney disease
What are the indications for Renal Replacement Therapy (RRT) with dialysis in Acute Kidney Injury (AKI)? The common indications: Uremia Life threatening volume overload refractory to medical treatment Life threatening hyperkalemia refractory to medical treatment Life threatening metabolic acidosis refractory to medical treatment Life threatening intoxication with a dialyzable drug This leaves the
Hypertension is a prevalent issue in dialysis patients. Mechanisms of Hypertension in ESRD patients Sodium and Volume Overload Sympathetic Overactivity Renin Angiotensin System Activation Sodium and Volume Overload The cornerstone of blood pressure control is volume management. In non ESRD patients with hypertension (HTN), sodium/ volume overload is a reason for an inability
Mineral bone disease in dialysis patients refers to assessment and management of Phosphorus, Calcium, and Parathyroid Hormone (PTH) Pathophysiology The kidney normally is responsible for excretion of phosphorus and conversion of inactive - 25- hydroxyvitamin D to active - 1,25-hydroxyvitamin D via the enzyme 1 alpha-hydroxylase. Therefore with kidney failure there is: Impaired
Nutrition is an important part of managing chronic dialysis patients so much so that each unit has a registered dietician. Things that I focus on when rounding on a dialysis patient include: Albumin - Malnutrition and protein energy wasting Potassium Bicarbonate - Acid Base status Vitamins - B complex/ C Diabetes Albumin -
Anemia is an almost universal finding in patients with End Stage Renal Disease requiring dialysis. The following factors contribute: Erythropoietin deficiency: The kidneys normally secrete erythropoietin which stimulates the bone marrow to produce red blood cells. When the kidneys fail, erythropoietin deficiency occurs with resultant anemia. Iron deficiency: Patients on hemodialysis have ongoing
Arteriovenous access is the preferred access for hemodialysis (as opposed to use of a catheter). There are 2 types of arteriovenous access Arteriovenous fistula (AVF) - native artery transposed to native vein. Native vein hypertrophies under increased arterial pressure. This becomes fistula. This is the preferred dialysis access (over both catheters and arteriovenous
