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Hemodialysis Case Study

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by

Emilie Wiedner

on 4 December 2014

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Transcript of Hemodialysis Case Study

A 26-year-old with diabetes mellitus has developed renal failure. While waiting for a kidney transplant, he is on maintenance hemodialysis eight to ten hours three times each week. He is on a diet restricted in sodium (500 mg/day), potassium (2.6 g/day), and protein as well as his usual diabetic diet. He has a shunt in his right wrist to allow for easy hookup to the dialysis machine.
Recorded Value Comparison
Blood Values Before Hemodialysis:
Serum sodium 120 mEq/L
Serum potassium 6.4 mEq/L
Serum chloride 102 mEq/L
Serum creatinine 16 mg/dL
Hematocrit 24%

Dialysis Fluid Values in Dialysis Machine
Sodium 134 mEq/L
Potassium 2.6 mEq/L
Calcium 2.5 mEq/L
Magnesium 1.5 mEq/L
Chloride 104 mEq/L
Sodium acetate 36.6 mEq/L
Anhydrous dextrose 2 g/L

Anemia and Dialysis
Hemodialysis vs Peritoneal Dialysis
The Difference between hemodialysis and peritoneal dialysis
Hemodialysis Case Study
Prior to hemodialysis, his representative blood values are the following:

Serum sodium 120 mEq/L
Serum potassium 6.4 mEq/L
Serum chloride 102 mEq/L
Serum creatinine 16 mg/dL
Hematocrit 24%

The dialysis fluid in the kidney dialysis machine contains the following:

Sodium 134 mEq/L
Potassium 2.6 mEq/L
Calcium 2.5 mEq/L
Magnesium 1.5 mEq/L
Chloride 104 mEq/L
Sodium acetate 36.6 mEq/L
Anhydrous dextrose 2 g/L
Serum
: a protein-rich fluid that separates when blood coagulates
Solutes move through the dialysis membrane by diffusion passing between the blood into the dialysis fluid
Comparing blood solute concentrations before and after dialysis
Serum sodium: Increases
Serum potassium: Decreases
Serum Chloride: Increases
Serum Creatinine: Decreases
Hematocrit: Remains the same (this is because the pores of the dialysis tubing are too small to let red blood cells through)
Some solutes that pass from the dialysis fluid into the blood include
water
salts
calcium
acetate
anhydrase dextrose
What is Dialysis?
Dialysis
: The process of separating serum substances from the blood using a permeable membrane
Two types of dialysis:
hemodialysis
peritoneal dialysis
Dialysis is needed for kidney failure treatment in order to filter waste product from the blood
Anemia can be a critical complication as a result of hemodialysis
Anemia
: a condition where the body does not have enough red blood cells for oxygen transport in the body
This is due to a decrease in iron, vitamin B-12, and folic acid which is essential for hemoglobin formation
hemoglobin is needed for oxygen binding to red blood cells
Anemia can also be caused from blood loss during the connection of the body and hemodialysis machine
Hemodialysis
: a machine that helps filter urea and salts from blood and helps treat people who have renal failure. It also helps control blood pressure and balances fluids and minerals such as sodium and potassium
Peritoneal Dialysis
: a filtration process that removes waste products from the blood by using a peritoneal membrane (lining of abdominal cavity) as a filter
Most people prefer peritoneal dialysis because it can be done from the comfort of your home and can also be done multiple times a day while performing normal activities
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