{"id":8303,"date":"2021-11-22T18:18:26","date_gmt":"2021-11-22T16:18:26","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/nephrology\/end-stage-kidney-failure-tasks-in-predialytic-stadium-dialysis-forms-and-indications\/"},"modified":"2022-01-12T01:21:48","modified_gmt":"2022-01-11T23:21:48","slug":"end-stage-kidney-failure-tasks-in-predialytic-stadium-dialysis-forms-and-indications","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/nephrology\/end-stage-kidney-failure-tasks-in-predialytic-stadium-dialysis-forms-and-indications\/","title":{"rendered":"End-stage kidney failure, tasks in predialytic stadium, dialysis forms and indications"},"content":{"rendered":"\n

ESRD<\/h3>\n<\/span>\n\n\n

ESRD is defined as an irreversible decline in kidney function to a degree in which dialysis or renal transplantation are required to continue sustaining life.<\/p>\n\n\n\n

  • Clinically, GFR <15 (stage G5 of KDIGO)<\/li>
  • ESRD can arise as a progression of CKD or as a result of AKI.<\/li>
  • Changes seen are fluid and sodium retention (HTN), calcium and bone disorders, anemia, hyperkalemia, acid-base disorders, endocrine disorders.<\/li>
  • The only way to keep sustaining life is dialysis or renal transplantation.<\/li><\/ul>\n\n\n<\/span>\n

    Pre-dialytic stage<\/h3>\n<\/span>\n\n\n
    • Once GFR levels start declining (KDIGO G4+), we should start preparing the patient for dialysis (pre-dialytic phase).<\/li>
    • Metformin cessation<\/li>
    • Contraindicated drugs: spirinolactone, tetracycline, aminoglycosides, sulfonamides, quinolones, NSAIDs<\/li>
    • Hemodialysis using a central-venous catheter<\/strong> if dialysis is needed before the placement of a permanent vascular\/peritoneal access.<\/li>
    • Arteriovenous fistula\/graft or peritoneal catheter placement.
      • An AV fistula<\/strong> is an done by attaching an artery to a vein, done under anesthesia. It takes up to half a year to heal, and the patient must exercise the hand to help the fistula mature.<\/li>
      • An AV graft<\/strong> uses an artificial tube (graft) to attach an artery to a vein. They heal and mature faster than fistulas, but tend to have more complications and don’t last as long.<\/li>
      • A peritoneal catheter <\/strong>is a connection between the outside world into the peritoneal cavity. It takes a few weeks to heal.<\/li><\/ul><\/li>
      • Depending on the country, patients can choose to switch from one form to the other.<\/li><\/ul>\n\n\n<\/span>\n

        Dialysis<\/h3>\n<\/span>\n\n\n

        Dialysis is used for the filtration of blood in case of renal failure. Its purposes are to eliminate waste, balance the electrolytes, prevent uremia, improve patients’ quality of life, and prolong it.<\/p>\n\n\n<\/span>\n

        Indications<\/h4>\n<\/span>\n\n\n
        • Any of the following resulting from renal insufficiency and unresponsive to therapy:
          • Fluid overload<\/li>
          • Hyperkalemia<\/li>
          • Hypercalcemia<\/li>
          • Metabolic acidosis<\/li>
          • Pericarditis<\/li>
          • Uremia<\/li><\/ul><\/li>
          • GFR <10<\/li>
          • Diabetes + GFR <15<\/li>
          • Some toxins<\/li><\/ul>\n\n\n<\/span>\n

            Types<\/h4>\n<\/span>\n\n\n
            • Hemodialysis (HD)<\/li>
            • Peritoneal dialysis (PD)<\/li><\/ul>\n\n\n<\/span>\n

              Hemodialysis<\/h4>\n<\/span>\n\n\n

              Hemodialysis involves direct filtration of the blood through a series of filters (dialyzer). It can be used for both acute and chronic kidney failure.<\/p>\n\n\n<\/span>\n

              Peritoneal dialysis<\/h4>\n<\/span>\n\n\n

              In peritoneal dialysis, the peritoneum is used as the filtration unit (“dialyzer”). It is used for chronic kidney failure. It is generally indicated for patients that have inadequate vascular access or prefer self-treatment.<\/p>\n<\/span>

              ESRD<\/h3>

              Pre-dialytic stage<\/h3>

              Dialysis<\/h3>

              Indications<\/h4>

              Types<\/h4>

              Hemodialysis<\/h4>

              Peritoneal dialysis<\/h4><\/div>","protected":false},"excerpt":{"rendered":"

              ESRD ESRD is defined as an irreversible decline in kidney function to a degree in which dialysis or renal transplantation are required to continue sustaining life. Clinically, GFR <15 (stage G5 of KDIGO) ESRD can arise as a progression of CKD or as a result of AKI. Changes seen are fluid and sodium retention (HTN), […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":685,"menu_order":14,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8303","page","type-page","status-publish","hentry"],"yoast_head":"\nEnd-stage kidney failure, tasks in predialytic stadium, dialysis forms and indications – Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/nephrology\/end-stage-kidney-failure-tasks-in-predialytic-stadium-dialysis-forms-and-indications\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" 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