Hemodialysis fxn: Usual Complications:

- Filters waste and water from the blood. 1. Hypotension

Causes of Renal Failure: Mgt:

- Hypertensive arteriolar nephrosclerosis - Stop UF immediately.

(progressive kidney damage caused by - Trendelenburg position
poorly controlled HPN) - 100-200cc Normal Saline Bolus
- Diabetic nephropathy (Common 2. Hypertension
complication of both type 1 & 2 - Catapres 75mg (MAX DOSAGE: 150mg)
diabetes. Def: Poorly controlled a) 1st dose: 75mg
diabetes) b) 2nd dose: 75mg (if BP is
- Chronic glomerulonephritis (Caused by still high)
frequent infx such as UTI, HIV, HepB) c) Nicardipine drip (if BP
- Polycystic kidney disease. (Cysts that remains high)
enlarges kidney and loses its function. 3. Chest pains
Becomes damaged over time.) - Give isordil.
- Gouty Nephropathy (also called "Uric WARNING: Don’t adm if pt’s bp is low.
Acid Nephropathy" due to an increase 4. Hypoglycemia
in uric acid - Give D5050
5. Hyperglycemia
Types of Permanent Access:
- Insulin
1. AV fistula (connected blood vessels) WARNING: Don’t adm before tx. This
2. AV graph (foreign body) will lead to hypoglycemia.
6. Cramps
Best area to check (???) - Massage or Bolus
- 2-3 inches above the anastomosis Health teaching:
(surgical connection between two
structures (blood vessels)). 1. Limit fluids <750ml – 1L/day
2. Avoid fruits (↑ed K), Dairy (↑ed Ca)
Indication for end stage renal failure

1. GFR (Glomerular filtration rate) <15ml/min

Standard Dialysis treatment time: 4hrs

Dialysis disequilibrium syndrome

- Happens during a dialysis in patients

who missed frequent sessions. It is due
to rapid clearance of substances.
- S/S: headache, confusion, blurred vision