Chronic Renal Failure - College of Pharmacy-Handout2012

Labs na140 k52 co226 bun 45 cr32 ca85 albumin32

Info icon This preview shows pages 48–64. Sign up to view the full content.

View Full Document Right Arrow Icon
Labs: Na=140, K=5.2, CO2=26, BUN= 45, Cr=3.2, Ca=8.5, Albumin=3.2, Phos=4.9, Mg=1.8, PTH=70, Hgb=11, Hct=35 PE: Ht=5’5”, Wt=130#
Image of page 48

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Patient Case #1 What are AK’s sign and symptoms of CKD? ROS: Mild edema in lower extremities, noted recent weight gain of 10 lbs, along with dry, pale skin . Labs: Na=140, K=5.2 , CO2=26, BUN= 45 , Cr=3.2, Ca=8.5, Albumin=3.2, Phos=4.9 , Mg=1.8, PTH=70, Hgb=11, Hct=35
Image of page 49
Patient Case #1 What is AK’s renal function? Ht=5’5” (IBW= 57 kg), Wt=130# (59 kg), Age = 26 Cockcroft-Gault! (140-age)(IBW)/(72)(SrCr) * 0.85 for females (140-26)(57)/(72)(3.2) * 0.85 = = 24 ml/min
Image of page 50

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Measured creatinine clearance versus the modification of diet in renal disease and Cockcroft-Gault equations for the assessment of renal function Amber E. King, Pharm.D. Kishor Gandhi, M.D., M.P.H. Genevieve D’Souza, M.D. Cindy Wordell, Pharm.D. Eugene R. Viscusi, M.D. Treatment of Chronic Renal Failure
Image of page 51
Dialysis and Transplantation Dialysis is primary treatment for ESRD Transplantation is limited by available organs, health of patient, personal preference, age? Dialysis plays important role in both acute and chronic disease Dialysis is life sustaining and serves as bridge to transplantation
Image of page 52

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Dialysis Indications Uremia (n/v, anorexia, fatigue, cardiac/pulmonary symptoms) Acid/base disorder (acidosis) Fluid overload Electrolytes (hyperkalemia) Overdose Hemodialysis and Peritoneal Dialysis
Image of page 53
Hemodialysis Consists of three components Blood compartment Dialysis solution Semi-permeable membrane Water and solute transport through a semi-permeable membrane for removal of excess fluid or waste products Solute flow is determined by concentration, molecular weight, filter size, and pressure gradient Replacement of substances can be added to multiple different dialysate solutions
Image of page 54

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 55
Hemodialysis Solutes removed by diffusion (down a gradient) and by convection (removal of solutes dissolved in ultrafiltrate) Diffusion: removes relatively low molecular weight solutes Convection: removes some high molecular weight solutes Diffusion and convection can be controlled independently and thus titrated to individual needs of the patient
Image of page 56

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 57
Hemodialysis Blood moves from arterial blood thru dialysis machine and back to the venous blood supply Complications include: Clotting Hypotension Chest pain Performed 3 times weekly for 3-4 hours Continuous dialysis or CRRT in acute setting
Image of page 58

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Hemodialysis
Image of page 59
Peritoneal Dialysis Same three components as hemodialysis Blood compartment Dialysis solution Semi-permeable membrane Peritoneum serves as the semi-permeable membrane Surgically placed catheter provides access to the peritoneal cavity Dialysate is instilled into cavity and allowed to dwell for a period of time
Image of page 60

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Peritoneal Dialysis
Image of page 61
Peritoneal Dialysis Replacement of substances can be added to dialysate During the dwell solutes and fluid diffuse into the dialysate Dialysate is drained and replaced or capped until next treatment Variety of solutions are available to titrate to individual patient needs
Image of page 62

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Peritoneal Dialysis
Image of page 63
Image of page 64
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern