RENAL REPLACEMENT THERAPY

January 29, 2018 | Author: Anonymous | Category: Science, Health Science, Immunology
Share Embed Donate


Short Description

Download RENAL REPLACEMENT THERAPY...

Description

RENAL REPLACEMENT THERAPY Dr Shafaq Nazir House physician Medical unit 1

                 

Contents

DEFINATION CRITERIA FOR RRT HEMODIALYSIS AND ITS COMPLICATIONS HEMOFILTERATION AND COMPLICATIONS PERITONEAL DIALYSIS AND COMPLICATIONS RENAL TRANSPLANT TRANSPLANT STATISTICS TRANSPLANT REQUIREMENTS. INDICATIONS CONTRA INDICATIONS SOURCES OF DONORS COMPATIBILITY PROCEDURE COMPLICATIONS KIDNEY PANCREASE TRANSPLANT TRANSPLANT REQUIREMENTS COMPLICATIONS MCQs

RRT  IT IS A TERM USED TO ENCOMPASS LIFE SUPPORTING TREATMENTS FOR RENAL FAILURE.  It includes    

HEMODIALYSIS PERITONEAL DIALYSIS HEMOFILTERATION RENAL TRANSPLANT

Criteria for placing a patient for RRT Presence of uremic syndrome i.e 1. Hyperkalemia(unresponsive to conventional therapy) 2. Extra cellular volume expansion 3. Acidosis refractory to medical therapy 4. Bleeding diathesis 5. Creatinine clearance10ml/min per 1.73m sq

HEMODIALYSIS  It removes waste products like potassium and urea as well as free water from blood in renal failure.  Principle revolves around diffusion of solutes across semi permeable membrane  Dialysate flows opposite to blood flow direction in extra corporeal circuit.  This counter current flow maintains concentration gradient increasing efficacy of dialysis.

COMPLICATIONS OF HEMODIALYSIS        

DECREASE IN BLOOD PRESSURE FATIGUE CHEST PAIN LEG CRAMPS NAUSEA HEADACHE SEPSIS LEADING TO ENDOCARDITIS OSTEOMYLITIS HEPARIN ALLEGRY(RARE) LONG TERM COMPLICATIONS LIKE  AMYLOIDOSIS  NEUROPATHY  HEART DISEASE

HEMOFILTERATION  Similar to hemodialysis as it also requires a semi     

permeable membrane However, governed by convection rather than by diffusion Dialysate is not used Requires a positive hydrostatic pressure driving water and solutes to filterate compartment Both small and large solute particles are dragged through, due to hydrostatic pressure. High quality replacement fluid(isotonic) is used as ultrafilterate substitute .

HEMOFILTERATION OUTCOME ADVANTAGES:  Less hemodynamic instability  No exposure to dialysis fluid DISADVANTAGES:  more expensive than hemodialysis

PERITONEAL DIALYSIS  Works on the principal of peritoneal membrane     

acting as a natural semi-permeable membrane Dialysis fluid when instilled around it is removed by diffusion, excessive fluid by osmosis(by altering conc of glucose in fluid.) Simple to perform Less complex Used both children and elderly In diabetics and cardiovascular diseases

TYPES OF PERITONEAL DIALYSIS  Continuous ambulatory peritoneal dialysis  Automated peritoneal dialysis  CAPD uses smallest quantity of of fluid daily to      

prevent uremia 2L bags are changed 3-5 times a day A total dialysate of 10L is produced. APD involves cyclic peritoneal dialysis, Intermittent peritoneal dialysis Night intermittent dialysis Tidal intermittent dialysis

SIDE EFFECTS OF PERITONEAL DIALYSIS        

Peritonitis(staph 60%, gram –ve 20%, fungi
View more...

Comments

Copyright � 2017 NANOPDF Inc.
SUPPORT NANOPDF