Dialysis

Question 1

When is dialysis started?

Answer 1

In chronic patients when GFR < 10-15 mL/min/1.73 m^2 (of body surface area) or start in acute kidney injury if the following are refractory to medical treatment: (AEIOU) acidosis, electrolyte abnormality, ingestion, volume overload, uremia

Question 2

What is hemodialysis?

Answer 2

Clearance of solutes and water from the blood through a semipermeable membrane

Question 3

What are the physiological principles of dialysis?

Answer 3

1. Diffusion: removal of solutes down a concentration gradient.
2. Convection: removal of solutes by means of a hydrostatic pressure gradient

Question 4

How is hemodialysis access achieved?

Answer 4

1. Surgeons create a fistula
2. Arteriovenous graft
3. or catheter for acute dialysis

Question 5

Describe peritoneal dialysis

Answer 5

1. Instead of using blood, you use the patient’s abdomen. The dialyzer is no longer a tube but is the peritoneal membrane itself
2. This method avoids dramatic fluid shifts and drops in blood pressure. It also allows for home therapy.