Renal Replacement Therapy

The option that is most frequently used to treat the disease is dialysis. Dialysis takes a person blood and passes it through an artificial dialyzer which removes toxins and extra fluids from the patient’s blood. In addition to the “Core curriculum for the dialysis technician: a comprehensive review of hemodialysis” dialysis can be done in centers or at the patient’s own home, most of the time it’s done in centers three times a week for four hours.

When discussing management of CKD with a primary care provider it is up to the patient and the team to create a viable plan. "most patients require dialysis, either peritoneal dialysis (PD) or hemodialysis (HD). The majority of patients in the United States chose HD" (Hadley, 2014 p. 1116). All options should be discussed with the patient before determining any set course of actions. Alternative therapies can include; dialysis, transplantation, and even palliative care (Hadley, 2014, p. 1116). With dialysis being the mainstay of management when the kidneys start to fail (stage 5,) different options should be discussed. With numerous dialysis centers and at home options being available the pros and cons of each should be carefully measured. Fresenius Medical Care has locations throughout Northern Colorado, including Greeley and Loveland. They

In dialysis, blood is circulated through an extracorporeal circuit for long periods of time. During this process the blood can begin to develop clot formations throughout the CVC, extracorporeal circuit, and the dialyzer itself; which causes multiple complications for the dialysis patient. In order to minimize or eliminate the

CAPD- Continuous Ambulatory Peritoneal Dialysis. When your kidneys begin to fail your blood is not clean properly and you are not able to get rid of extra waste products in your body. Continuous Ambulatory Peritoneal Dialysis replaces the work of a failed kidney, it cleans your blood and also helps to control water. A permanent catheter is placed in the abdomen whilst under local/general anaesthetic. It might be necessary for you to stay in hospital for 24-48 hours following the procedure which has just taken place, during your short stay in hospital you may have some dialysis. One to three litres of dialysis fluid are run through the catheter and into the peritoneal cavity, this fluid remains in the cavity for several hours before being drained.

Mark is a four year old male who has been diagnosed with chronic renal failure. Mark has two older brothers, John and Max. His mom, Carol, is a teacher at the local elementary school. His dad, Mike, is a community police officer. Mark goes to preschool from 0800-1200 four days a week. They live in a rural community in small four bedroom house with their dog, Bruno. Everyone in the community seems close and supportive. Both Mark’s older brothers caught strep throat at school and then Mark caught it. The strep wasn’t treated for two weeks as his mother thought his symptoms were allergies. Mark was in the clinic with his mom with symptoms of decreased urine output, rusty colored urine, and swelling of the abdomen. The doctor diagnosed him

Nurses are using technology devices such as IV monitors, computers, cardiac monitors, medication dispensing machines, portable defibrillators, and patient remote monitoring devices every day to improve patients’ quality of life. Working as a hemodialysis nurse allows me to use more advanced technology ‘hemodialysis machines and reverse osmosis devices’ while performing the hemodialysis treatment on patients. The hemodialysis machine monitors the flow of the blood while it is outside the patient and remove the waste products and the extra fluids from the body. This machine will alarm if anything goes wrong during the treatment. This machine can be considered as a safe artificial kidney that help people with kidney failure or impairment to sustain their

Describe complications that can occur as a result of dialysis and identify nursing measures that are designed to prevent these complications.

What happens when your kidneys fail? Acute renal failure is a disorder of the kidneys when it’s ceased to perform its functions. For example, the kidneys lose its ability to excrete wastes. When your kidneys fail because of a disease or injury, wastes and extra fluid can build up in the blood and make you sick. Kidneys will not be able to maintain homeostasis of electrolytes. A high level of plasma potassium, sodium concentration, and elevated pH will be evident as well.

The most commonly evaluated clinical parameter measured in the ESRD population is the delivered dose of dialysis is by Kt/V. In this case, majority of the diabetic and non-diabetic population has an adequate dialysis based on their Kt/v (sp). But still many factors are needed to be considered. We should identify the possible causes for those patients who did not meet their required clearance. Check the patient’s vascular access. A Good vascular access provides adequate dialysis. Observe proper cannulation technique and rotate sites to prevent damage of the access. Proper priming should be observed to utilize the surface area of the dialyzer. Clotting of blood due to inadequate heparinization does not produce adequate clearance. The nurse should administer heparin per facility protocol or as ordered by the doctor. Monitor patient’s Kt/V through online clearance monitoring (OCM) to immediately evaluate the current urea clearance of the patient and to provide a prompt intervention and investigation as necessary.

Dialysis is a life-saving treatment for adults and children with acute and chronic kidney failure. While it is a life-saving treatment, it can also be life threatening. There are steps and precautions that a healthcare professional must take when assisting a patient with the initiation of dialysis treatment. Patients must also take personal precautions. Training is provided to patient care technicians, nurses and other direct patient care staff. This is to ensure the safety of the patients by having knowledgeable and educated staff. Patients are also trained on certain aspects of the treatment to ensure they receive proper care.

Kidney failure, also known as acute renal failure or acute kidney injury, occurs when the kidneys are unable to filtrate the waste products from our body from the blood. When those wastes are not removed from the blood, dangerous levels of wastes could assemble and the chemical makeup of the body could loose the balance. Renal failure can develop very fast over the time of a few hours to a few days and is more common in people, who are already moved to the hospital, especially people, who are

The three phases include; oliguria, diuresis, and recovery. Oliguria starts within one day after a hypotensive even and can last between one and three weeks. Moreover, it can regress in several hours or extend for several weeks. The stent of oliguria depends on the duration of ischemia or the severity of the toxic injury. Specifically, there is approximately between ten and twenty percent of cases that have non-oliguric failure. The BUN and plasma creatinine concentrations increase, however the urine output may vary in volume. Also, other various manifestations are dependent on the underlying cause of the renal failure. When the renal function improve, the urine volume increases and is progressive. However, during the beginning of the diuretic phase the tubules are still impaired. So, both the fluid and electrolyte balance need to be closely monitored due to excessive urinary losses needing to be replaced. An index of renal function during the recovery phase is provided my serial measurements of plasma creatinine. In order normal status to return is may take anywhere from three to twelve months. Furthermore, about thirty percent of individuals do not have a full recovery of a normal GFR or tubular

In Kidney failure cases urea, creatine, uric acids and electrolytes move from the blood to the dialysate with the net effect of lowering their concentration in the blood. RBC s WBC s and plasma proteins are too large to diffuse through the pores of the membrane. Hemodialysis patient are exposed to 120 to 130 L of water during each dialysis treatment. Small molecular weight substances can pass from the dialysate in to patient’s blood. So the purity of water used for dialysis is monitored and controlled.

There can be problems with fluid leaks in the groin or around the catheter when dialysis starts. Infections are the major risk - either in the exit site or most importantly in the tummy itself, peritonitis. In the long term, there can be a thickening of the peritoneal membrane so that it does not work efficiently. The dialysis fluid may need to be changed or switched to haemodialysis.

The number of patients with end-stage renal disease (ESRD) requiring hemodialysis is constantly rising worldwide.1 Vascular hemodialysis access is considered the lifeline for patients with end-stage renal disease, and arteriovenous fistula (AVF) has been the golden standard access for hemodialysis.2 In Europe, over 25% of all hospital admissions for ESRD are for the construction or maintenance of a patent vascular hemodialysis access.3