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PO ).
4
9, 1% Haemodialysis
7, 1%
CAPD
Median survival
age 45–54 is currently 10.5 years
age 55–64 it is 5.6 years
age 65–74, 3 years
Haemodialysis apparatus
Mechanisms of solute transport
1. Diffusion: movement of substances from an area of
higher concentration to an area of lower
concentration of solutes.
AEIOU
Acidosis: pH<7.2
Electrolyte abnormalities:
life-threatening hyperkalemia associated with ECG
changes
symptomatic hypermagnesemia and hypercalcemia
Indications for dialysis
Intoxications: Xtics of dialysable substances
Low molecular weight (<500 Da)
High water solubility
Low degree of protein binding
Small volumes of distribution (<1 L/kg)
High dialysis clearance relative to endogenous clearance
Uraemic gastritis,
GI bleeding
Pericardial effusion
Haemorrhagic stroke
Recent surgery
Post transplant patients
Anticoagulation
Advantages include
Abundance in renal failure
Ease of measurement,
Wide volume of distribution
Good dialyzability
Dialysis Adequacy
Kt/V: is a ratio that relates the volume of cleared
plasma (Kt) to the volume of urea distribution (V).
K = dialyser urea clearance.(ml/min)
t = time on dialysis.(min)
V = volume of distribution of Ur (estimated from patient
size).(ml)
Dialysis Adequacy
Describes the volume of urea cleared during a dialysis
session relative to the volume of urea distributed
throughout the body.
URR = (BUNpre–BUNpost)/BUNpre