2. INTRODUCTION
• is a process of purifying the blood of a person whose
kidneys are not working normally.
• achieves the extracorporeal removal of waste products such
as creatinine and urea and free water from the blood when
the kidneys are in a state of renal failure.
3.
4.
5. INDICATIONS
• EMERGENCY
1. Severe metabolic acidosis
2. Electrolyte disbalance
3. Acute intoxication
4. Features of fluid overload
5. Uremic features: encepthalopathy
pericarditis
gastropathy
Maintainance hemodialysis
1.ESRD
6. APPROACH
• SELECTION OF PATIENT AS INDICATED
ACCESS
1.AV FISTULA
Advantage:
Low infection rate
Higher blood flow rate
Lower chances of stenosis/thrombosis
Disadvantage:
Longer maturation time
Aneurysm formation
Higher chances of subclavian steal syndrome
8. 3.GRAFTS
Advantage:
• Can be used much sooner
Disadvantage:
• Higher infection rate
• Higher chances of re stenosis/thrombosis
• Steal syndrome
• pseudo aneurysms
9. ASSESSMENT OF PATIENT BEFORE STARTING DIALYSIS
CHECK IF ACCESS IS WORKING
HAEMOGLOBIN LEVEL
DRY BODY WEIGHT
BLOOD PRESSURE
S.UREA /S.CREATININE
CHEST X-RAY
14. 2.DEPRESSION
3.MI , CVA (A/w risk factors
HTN,Hyperlipidemia,hyperthyroidism,increased cardiac output d/t
anemia)
4.HIV, HEP B, NON A NON B HEPATITIS, CMV INFECTION