Is it a contraindication to give a person that had dialysis recently fluids? For example we had someone who had high blood sugar. His lungs were clear and we figured we give him some fluids for his hyperglycemia. At the hospital once they learned that he had dialysis earlier in the day they told us discontinue the bag. They didn't explain but apparently we should not have given him fluids because he had dialysis. Anybody know why?
Fluids bad after dialysis?
- Thread starter dalmain
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Brandon O
Puzzled by facies
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You need to be very sparing in general giving fluids to renal failure patients. That volume isn't going to go anywhere until their next cleansing.
I can't think of a reason why having "just had it" would be especially bad... except that it means he'll have to wait the maximum time (a couple days probably) with the extra volume on board.
I can't think of a reason why having "just had it" would be especially bad... except that it means he'll have to wait the maximum time (a couple days probably) with the extra volume on board.
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That's pretty much "it." You do have to be somewhat sparing with fluids with dialysis patients because they either produce very little urine or none at all, so there's no efficient way for them to get rid of the excess fluids. I would suggest that if you do give a dialysis patient extra fluid, you should try to keep as accurate a count of how much fluid you gave. That way the patient (and everyone else) should know how much extra fluid has been given. The patient should also usually know how much fluid was taken off during their last session, though that's not always reliable either.
The kidneys are also needed for electrolyte balance, so if they're not functioning, and the dialysis is a bit off, there can be some significant electrolyte abnormalities and adding fluid could make things worse as well. Best to just be very careful about fluids in dialysis patients.
The kidneys are also needed for electrolyte balance, so if they're not functioning, and the dialysis is a bit off, there can be some significant electrolyte abnormalities and adding fluid could make things worse as well. Best to just be very careful about fluids in dialysis patients.
Ewok Jerky
PA-C
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Kidneys filter blood. Pts on dialysis don't have functioning kidneys. As such they don't regulate their own electrolytes or volume status. So what ever sodium and water you gave he has to keep with him until his next session. Probly not a big deal but...
I would generally refrain from giving fluids unless it was absolutely necessary, not just your run if the mill hyperglycemia.
Not in your usual prehospital medicine course, live and learn.
I would generally refrain from giving fluids unless it was absolutely necessary, not just your run if the mill hyperglycemia.
Not in your usual prehospital medicine course, live and learn.
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Which is why I like this place!
Just to reiterate what several others have said, the use of IV fluids should be judicious in patients with end-stage renal disease.
That being said, don't let that keep you from giving these patients fluids when indicated. Stable hyperglycemia probably doesn't need pre-hospital fluid resuscitation. But hypotension in a dialysis patient definitely deserves a fluid challenge.
Especially after a recent HD session.
That being said, don't let that keep you from giving these patients fluids when indicated. Stable hyperglycemia probably doesn't need pre-hospital fluid resuscitation. But hypotension in a dialysis patient definitely deserves a fluid challenge.
Especially after a recent HD session.