Diseases List

ID 143
Name DIALYSIS
Cause
Signs Symptoms
Diagnosis
Investigations
Management Indications for dialysis: 1. Blood urea > 200mg/dl (or > 30mmol/l) 2. Serum creatinine > 10mg/dl (or > 600 mol/1) or BUN > 100mg/dl 3. If daily rise of blood urea is >40mg/dl 4. Serum K+ > 7 meq/1 5. Fluid overload, not controlled by fluid restriction and diuretics. 6. Severe metabolic acidosis, (pH < 7.20 or serum bicarbonate < 10meq/l). 7. Creatine clearence 3-4ml/min. 8. If uraemic pericarditis is present (uncommon in ARF). 9. If patient becomes comatose. Hemodialysis: Intermittent hemodialysis is still used in most of the renal units in the menagement of ARF, although ‘continuous haemofiltration technique’ is increasingly getting popularity now a day. In each time the procedure takes about 3-4 hours depending on the type of membranes used, the size of the patient, and other factors. Most patients require hemodialysis 3 times in a week. The advantage of haemodialysis that it can be performed at home at the patients convenience, but in that case the patient must be more knowledgeful about the treatment & procedure & a trained helper should be available. Peritoneal dialysis: Peritoneal dialysis is less efficient than haemodia-lysis & canot achieve satisfactory biochemical control in catabolic patients, rather it developts a major complication- peritonitis. So in most centres it is now been replaced by haemodialysis or continuous haemofiltration tachniques.
Introduction When conservative management fails to control uremic signs & symptoms in renal failure dialysis and kidney transplantation are the alternatives.
History
Etiology
Clinical Features
Preventions
Treatment
Complications
Prognosis
Types Types of dialysis: 1. Haemodialysis (intermittent technique) 2. Continuous arterio-venous (CAVS) or veno-venous haemofiltration (CWH) 3. Peritoneal dialysis
Classification
Observation
Pathology
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