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CKD Complications

A presentation about some common complications in patients on dialysis for nurses and patients.
by

Adam Wolfe

on 12 August 2010

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Transcript of CKD Complications

Adam Wolfe, PharmD. Student
Dan Clegg, PharmD. Student Prepared by: http://kidney.niddk.nih.gov/Kudiseases/pubs/CKD_Mineral_Bone/
http://kidney.niddk.nih.gov/Kudiseases/pubs/anemia/ http://kidney.niddk.nih.gov/Kudiseases/pubs/eatright/index.htm Why does it happen? Anemia 101 Fatigue Do I ever need IV iron? POP QUIZ Break it down! Activated by Kidney

Helps bring in calcium from food The Players POP QUIZ Red blood cells Inside Bones Epo released from Kidney Iron Anemia worsens as kidney disease progresses Kidneys need help to
stimulate bone marrow May be needed Feeling cold Shortness of Breath Trouble Concentrating Dizziness Anemia is a shortage of a. fluid-loaded blood plasma
b. Oxygen-carrying red blood cells
c. Infection-fighting white blood cells
d. Blood clotting factors Calcium Phosphorus PTH Vitamin D Magnet for Calcium Building blocks
for bones Regulates calcium in the blood Why should you limit sodium?
a. Makes you thirsty
b. Raise stroke and heart
disease risk
c. Increases edema
d. All of the above Why should you not drink
brown sodas?
a. High in Potassium
b. High in Phosphorus
c. Turn your stomach brown
d. There is no problem with soda, the dialysis will take care of it 2nd most common
mineral in body POP! QUIZ 1. Why do I take Renvela?
a.To make my food taste better
b.To bind phosphorus
c.To help digest food
d.To supplement calcium 2. Do I always need to receive Zemplar? 3. Bone disease occurs when too much phosphorus in the blood pulls what mineral from the bone?
a. Zinc
b. Calcium
c. Iron
d. Potassium Fluid = H2O + Mrs. Nephron AM: The Next Day... Wakes up to get to the Dialysis Center

Her shoes feel tight



Looks puffy in the mirror


She weighs in at the center at 85 kg

Her target weight is 80 kg

What could she have done differently? Total Fluid = 3000 mL Bottom line Calcium PLUS too much phosphorus
Bone formation where it shouldn't be Elasticity Rigidity VS Mrs. Renal She eats 3 good meals per day plus snacks Often she comes into dialysis itching What could explain the itching? Longer-term New Meds Mineral Bone Disorder Mrs. Kidney has this problem with her leg So after dialysis she goes to the doctor The doctor says it is cellulitis and gives her an antibiotic What should she mention to the doctor? 1. Tell the doctor 2. Ask about the medicine 3. Tell the dialysis nurse 1000 milliliter = 1 Liter 1 Liter = 1 kilogram Fluid Limit 1500 mL PLUS! it will be easier on her heart and breathing (and yours!) What does the dialysis center monitor?
iron panel
none are better than any other TIPS! so you'll feel better at the clinic
at the pharmacy
at the dialysis center Interactions! = FLUIDS Epogen does that! Lunch Snack Dinner Snack Bedtime AM: Lunch Snack Dinner Snack Bedtime Let's chat about dialysis stuff She also...
Fills her 64 oz drink at every gas station,
Has a glass of water with each TV show Now she...
Fills a 32 oz cup with ice to the top,
Chews sugar-free gum while watching TV
Full transcript