Kidney Failure

[jefftherealmccoy]

I've been on a few calls with people in kidney failure and having different types of problems due to dialysis lately. anyone got any good reading on kidney function, the dialysis process, and complications from it? Preferably something that's not too long winded.

 

[VFlutter]

http://www.icufaqs.org/CVVH.doc

 

[Aidey]

anyone got any good reading on kidney function, the dialysis process, and complications from it? Preferably something that's not too long winded.

That is an absolute contradiction.

The short version is "they're buggered". Anything beyond that is going to be long winded.

 

[FLdoc2011]

http://emedicine.medscape.com/article/1918879-overview

 

[Akulahawk]

That is an absolute contradiction.

The short version is "they're buggered". Anything beyond that is going to be long winded.

Yep. After "buggered" you pretty much have to get a bit long winded to begin to understand kidney failure, dialysis, and the complications associated with it.

http://www.icufaqs.org/CVVH.doc

The linked document give an idea of some of the complexities. I'm not that well versed in this stuff yet, but... some of that's partly because I've not had a patient that was on dialysis while I had them. Even with that, it should be clear that there's a lot more to these patients than hooking them up to the machine and letting it run...

 

[MSDeltaFlt]

I've been on a few calls with people in kidney failure and having different types of problems due to dialysis lately. anyone got any good reading on kidney function, the dialysis process, and complications from it? Preferably something that's not too long winded.

Here in the Miss. Delta roughly 60% of our patients, at least, have ESRD and are on Hemodialysis. You can't throw a rock without hitting 10 people sporting a shunt in their arm.

Some can pee a little bit. Most can't... at all. Took a critical care class where a MD said, "To pee is to be. If you don't pee you won't be."

Kidneys don't work. So they don't pee. They kinda tend to stay in fluid overload. So they're usually hypertensive. Very hypertensive. Fluid's gotta go sonewhere. Usually lungs (APE) and any and all dependent body parts (feet, et al).

Potassium is excreted through the kidneys. If they don't work you can't get rid of it. So a renal patient is usually hyperkalemic. A K of 6 or 7 is not unheard of. Saw one with a K of 9 get admitted. Pt's nephrologist told me she treated a pt with a K of 13. Pt was eventually discharged back home. Wow.

Shunts get infected and go bad. They'll tell you which arm, if any, you're allowed to stick and get BP's.

What else you want to know?

 

[Dwindlin]

Here in the Miss. Delta roughly 60% of our patients, at least, have ESRD and are on Hemodialysis. You can't throw a rock without hitting 10 people sporting a shunt in their arm.

Some can pee a little bit. Most can't... at all. Took a critical care class where a MD said, "To pee is to be. If you don't pee you won't be."

Kidneys don't work. So they don't pee. They kinda tend to stay in fluid overload. So they're usually hypertensive. Very hypertensive. Fluid's gotta go sonewhere. Usually lungs (APE) and any and all dependent body parts (feet, et al).

Potassium is excreted through the kidneys. If they don't work you can't get rid of it. So a renal patient is usually hyperkalemic. A K of 6 or 7 is not unheard of. Saw one with a K of 9 get admitted. Pt's nephrologist told me she treated a pt with a K of 13. Pt was eventually discharged back home. Wow.

Shunts get infected and go bad. They'll tell you which arm, if any, you're allowed to stick and get BP's.

What else you want to know?

Bodies are good at dealing with chronic changes. Wouldn't really bat an eye of a potassium around 6 - 8 in someone with long standing renal failure. 13 is pretty high, but again, body compensates pretty well, so when you're new set point is around 7-ish, 13 isn't terrible.

 

[Carlos Danger]

I've been on a few calls with people in kidney failure and having different types of problems due to dialysis lately. anyone got any good reading on kidney function, the dialysis process, and complications from it? Preferably something that's not too long winded.

If you aren't willing to read "long-winded", you can't learn renal physiology.

 

[fma08]

If you aren't willing to read "long-winded", you can't learn renal physiology.

^^ This.

 

[Ewok Jerky]

functions of the kidney:
-waste removal (BUN, creatinine)
-maintain blood pressure/fluid management (excrete or reabsorbs H2O)
-helps stimulate production of red blood cells
-acid/base balance
-electrolyte balance
-medication metabolism and excretion

so your patient on dialysis either cant do, or has extreme difficulty doing, all of the above.

check out dr najeeb on youtube

 

[Akulahawk]

Here in the Miss. Delta roughly 60% of our patients, at least, have ESRD and are on Hemodialysis. You can't throw a rock without hitting 10 people sporting a shunt in their arm.

I was thinking that you can't swing a Schrödinger's cat without hitting 10 people sporting a shunt...

 

[MSDeltaFlt]

I was thinking that you can't swing a Schrödinger's cat without hitting 10 people sporting a shunt...

See, now you're tossing out quantum theory. If you tossed out one electron, you coukd hit them all simultaneously.

 

[Akulahawk]

See, now you're tossing out quantum theory. If you tossed out one electron, you could hit them all simultaneously.

Or not.:wacko:

 

[MSDeltaFlt]

Or not.:wacko:

Eh, it's all relative.:blink:

 

[Akulahawk]

Eh, it's all relative.:blink:

Sadly, (and to get back on topic) that's part of the problem. Darned genetics... you get it from your relatives!