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Chronic Kidney Disease 40,459 views Share Like Download ...
Andre Garcia, Medical Doctor (MD) at USF Forte Follow
Published on Jul 23, 2008
FREE Medical eBooks => http://asgarcymed.blogspot.com/ ... Published in: Health & Medicine 4 Comments 163 Likes Statistics Notes
Full Name Comment goes here. 12 hours ago Delete Reply Block Are you sure you want to Yes No Your message goes here Chronic Kidney Disease
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- Severe metabolic acidosis (pH < 7.20)
- Neurologic symptoms such as seizures or neuropathy
31. 32. Chronic Kidney Disease
- Hemodialysis (choice for 90% of pts)
- Vascular access accomplished by an a/v fistula (preferred) or prosthetic graft
- Infection, thrombosis, and aneurysm formation are complications seen more often in grafts than fistulas. Staphylococcus aureus is most common infecting agent
- Pts typically require hemodialysis 3x/wk…sessions last 3-5 hrs each
- Home dialysis also now available
- Ensure pt getting regular labs to include PTH and ALK PHOS
32. 33. Chronic Kidney Disease
33. 34. Chronic Kidney Disease
- The peritoneal membrane is the “dialyzer”
- Most common type is continuous ambulatory peritoneal dialysis (CAPD)
- Pts exchange dialysate 4-6 times/day
- Continuous cyclic peritoneal dialysis (CCPD) utilizes a cycler machine to automatically perform exchanges at night
- Most common complication = peritonitis
Chronic Kidney Disease - Dx made by documenting elevations of BUN and serum creatinine co...
- Most common pathogen = S aureus
34. 35. Chronic Kidney Disease 35. 36. Chronic Kidney Disease - Total costs of both types of dialysis are about the same ($35,000 - $60,000/yr)
- Pts undergoing dialysis have an average life expectancy of 3-4 yrs
- Studies are conflicting regarding the survival advantage assoc. with either peritoneal dialysis or hemodialysis
36. 37. Chronic Kidney Disease - 1st - Dr Hamburger in 1952
- Up to 50% of all pts with ESRD are suitable for transplant. Age becoming less of a barrier
- In general, not placed on list until GFR