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Comprehensive Guide to
Hemodialysis Concepts
Hemodialysis Final Exam Concepts
The Three Endocrine Functions of the Kidney
Erythropoietin : A hormone that regulates red blood cell production. Renin : A hormone that affects sodium and potassium balance, as well as blood pressure. Calcitriol : The active form of vitamin D3 needed to absorb calcium from food.
Kidney Anatomy and Function
The functional unit of the kidney is the Nephron. Approximately 1% of the water filtered by the kidney is excreted in 24 hours.
Dialysate Parameters
The acceptable pH range for dialysate is 6-. The acceptable conductivity range for dialysate is 13.0-15.. The acceptable temperature range for dialysate is 35-39°C.
Dialysate Composition
The three components of dialysate are: 1. Reverse Osmosis Water 2. Acid Concentrate 3. Bicarbonate solution
Electrolytes in Dialysate
The electrolytes found in dialysate include: - Sodium - Calcium - Magnesium
Causes of Renal Failure
The top two leading causes of Renal Failure are: 1. Diabetes Mellitus 2. Hypertension
Other causes include glomerulonephritis and polycystic disorders.
Comparison of Peritoneal Dialysis and Hemodialysis
Peritoneal Dialysis (PD) : 1. Daily procedure 2. Performed at home 3. Occurs in the peritoneal membrane 4. Less dietary and fluid restrictions
Hemodialysis : 1. Performed 3 times per week 2. Usually done at a dialysis center 3. Occurs in an extracorporeal dialyzer 4. Stringent dietary and fluid restrictions
Dialyzer Pressure and Flow
The pressure is negative in the dialysate compartment of the dialyzer. Countercurrent flow is the exchange mechanism where blood and dialysate flow in opposite directions, allowing for diffusion and osmosis to occur simultaneously.
Bicarbonate in Dialysate
Bicarbonate in the dialysate: - Provides electrolytes for the dialysate - Acts as pH buffers to neutralize metabolic acidosis, substituting the kidney's pH balancing function
Role of a Renal Dietician
The renal dietician develops a meal plan based on the patient's nutritional needs and dietary preferences.
Lowering Phosphorus
Patients can lower their phosphorus levels by: 1. Reducing phosphorus consumption 2. Taking phosphate binders
Foods High in Potassium and Phosphorus
High Potassium Foods : - Bananas, Potatoes, Tomatoes, Oranges, Spinach, Melons, Avocado
High Phosphorus Foods : - Milk, Cheese, Nuts, Chocolate, Cola drinks
Dialysis-Related Concepts
Hyperkalemia : Elevated potassium levels Diffusion : The movement of solute from an area of greater concentration to an area of lesser concentration Ultrafiltration : The movement of solvent (water) from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure Recirculation : When dialyzed blood returning through the venous needle re-enters the extracorporeal circuit through the arterial needle Infiltration : Accumulation of excess substance in tissue or cell, resulting in a hematoma Hemolysis : Rupture or destruction of red blood cells Endotoxin : Toxic particles left behind by dead bacteria Reverse Osmosis : A form of water filtration where hydraulic pressure causes water to move from regions of low water concentration (high
