2023-11-05T23:17:22+03:00[Europe/Moscow] en true <p>eGFR &lt; 30ml/min </p>, <p>eGR &lt; 25ml/min </p>, <p> signs/symptoms of kidney failure, inability to control volume status/BP, progressive decline in nutritional status/cognitive impairment </p>, <p>b</p>, <p>b</p>, <p>a</p>, <p>b</p>, <p>b</p>, <p>c</p>, <p>c</p>, <p>cephalic vein + radial artery </p>, <p>Basilic or Cephalic vein + brachial artery </p>, <p>concentration of solute in blood/dialysate, solute characteristics, dialyzer membrane composition, blood/dialysate flow rate </p>, <p>Ultrafiltration </p>, <p>b</p>, <p>a</p>, <p>b</p>, <p>b</p>, <p>&lt;=500 daltons </p>, <p>3 sessions per week; 3-5 hrs each </p>, <p>5-7 sessions per week; 1.5-5 hours</p>, <p>3-7 short or long treatments</p>, <p>Urea reduction ratio (URR) </p>, <p>Kt/V</p>, <p>predialysis BUN- Postdialysis BUN/ predialysis BUN x 100</p>, <p>k= rate at which blood passes through dialyzer(ml/min); t= time on HD (min); V= patients volume of distribution of urea(ml)</p>, <p>tells us the urea made during dialysis and urea removed with fluid during dialysis </p>, <p>&gt;1.4</p>, <p>intradilaytic hypotension, chronic hypotension, intradialytic/post HD hypertension, muscle cramps </p>, <p>a,c </p>, <p>b</p>, <p>b</p>, <p>mupirocin ointment at exit site </p>, <p>empiric therapy; vancomycin + AG</p>, <p>high solute clearance (only 3 treatments a week), clearly defined adequacy; able to identify underdialysis quickly, low technique failure, close monitoring of patient </p>, <p>Travel to dialysis center, AE, issues w vascular access, rapid decline in residual renal function</p> flashcards
Hemodialysis

Hemodialysis

  • eGFR < 30ml/min

    When do we begin preparing the patient for dialysis?

  • eGR < 25ml/min

    When do we place an AV fistula?

  • signs/symptoms of kidney failure, inability to control volume status/BP, progressive decline in nutritional status/cognitive impairment

    When do we start dialysis? (3)

  • b

    Which requires no "maturity time"?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • b

    Which has the highest rates of thrombosis & infection?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • a

    Which has the longest survival time of placement device?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • b

    Which is used in patients with diabetes/severe vascular disease?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • b

    Which is the worst in terms of morbidity & mortality?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • c

    Which is used when vessels are not suitable for anastomosis/fistula?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • c

    Which takes only 2-3 weeks after placement to be ready for use?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • cephalic vein + radial artery

    AV Fistula =

  • Basilic or Cephalic vein + brachial artery

    AV Graft =

  • concentration of solute in blood/dialysate, solute characteristics, dialyzer membrane composition, blood/dialysate flow rate

    What does the rate of diffusion depend on? (4)

  • Ultrafiltration

    -Movement of water across the dialyzer membrane due to hydrostatic or osmotic pressure

  • b

    Movement of substances from high to low concentrations.

    a) Ultrafiltration

    b) Passive diffusion

  • a

    The primary means of removing excess fluid.

    a) Ultrafiltration

    b) Passive diffusion

  • b

    Which membrane is used more?

    a) Low flux

    b) High flux

  • b

    Which has a shorter treatment time?

    a) Low flux

    b) High flux

  • <=500 daltons

    What is the size of molecules that can pass through Low Flux membranes?

  • 3 sessions per week; 3-5 hrs each

    How does Typical Dialysis work?

  • 5-7 sessions per week; 1.5-5 hours

    How does Intensive Dialysis work?

  • 3-7 short or long treatments

    How does Home HD work?

  • Urea reduction ratio (URR)

    -the reduction in urea because of dialysis

  • Kt/V

    -fraction of the patient's total body water that is cleared of urea during a dialysis session

  • predialysis BUN- Postdialysis BUN/ predialysis BUN x 100

    URR formula?

  • k= rate at which blood passes through dialyzer(ml/min); t= time on HD (min); V= patients volume of distribution of urea(ml)

    In the Kt/V formula, what do each of the variables represent?

  • tells us the urea made during dialysis and urea removed with fluid during dialysis

    Why is Kt/V more accurate than URR?

  • >1.4

    What is the target Kt/V?

  • intradilaytic hypotension, chronic hypotension, intradialytic/post HD hypertension, muscle cramps

    What are the most common complications seen with HD? (4)

  • a,c

    Which has the highest rate of aneurysm and stenosis?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • b

    Which has the highest rate of thrombosis?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • b

    Which has the highest rate of infection?

    a) AV fistula

    b) Venous Catheter

    c) AV graft

  • mupirocin ointment at exit site

    How do we prevent infection in patients with Catheters?

  • empiric therapy; vancomycin + AG

    How do we treat infections?

  • high solute clearance (only 3 treatments a week), clearly defined adequacy; able to identify underdialysis quickly, low technique failure, close monitoring of patient

    What are the advantages of Hemodialysis? (5)

  • Travel to dialysis center, AE, issues w vascular access, rapid decline in residual renal function

    What are the disadvantages of Hemodialysis? (4)