Renal Replacement Therapy & Dialysis

Flashcards highlighting key vocabulary and concepts related to Renal Replacement Therapy and Dialysis.

Diffusion

Movement of small molecules (<500 Da) along a concentration gradient; main mechanism for removing urea and creatinine.

Ultrafiltration

Movement of water across a membrane, mainly to remove excess fluid, dependent on pressure gradient.

Convection

Movement of solutes along with water as pressure is applied; allows movement of mid to large molecular weight particles (>500-1000 Da).

Hemodialysis (HD)

A method of fluid removal using diffusion and convection, commonly used for CKD Stage V or emergent AKI; can be performed in a clinic, at home, or in a hospital.

AV fistula

Surgical connection between an artery and vein, creating extra pressure and blood flow into the vein for dialysis access; preferred due to good blood flow, longevity, and lower infection/clotting risk.

AV Graft

Synthetic graft connecting a vein and artery for dialysis access; takes 2–3 weeks before they can be used and has a higher risk of complications and lower survival compared to fistulas.

Central venous catheter

can be used immediately, but highest complication rate

Hypotension (in Hemodialysis)

A common complication of hemodialysis; Treatment includes bolus of NS or hypertonic saline or albumin; Prevention includes longer HD sessions, omitting antihypertensives on dialysis days, midodrine, or droxidopa.

Catheter Infection (in Hemodialysis)

A common complication of hemodialysis; treated with antibiotics and catheter removal.

Catheter thrombosis (in Hemodialysis)

A common complication of hemodialysis; can be treated with intraluminal alteplase or reteplase.

Peritoneal Dialysis (PD)

Uses the peritoneal cavity as the dialysate compartment and the peritoneal membrane as a semi-permeable membrane for diffusion and ultrafiltration.

Continuous ambulatory peritoneal dialysis (CAPD)

A type of peritoneal dialysis where the patient manually performs dialysate exchanges.

Automated peritoneal dialysis (APD)

A type of peritoneal dialysis using an automated cycler to perform exchanges, often with short-dwell exchanges during the night.

Peritonitis (in Peritoneal Dialysis)

A complication of PD; can be identified by cloudy effluent and abdominal pain. Treated with IP or IV antibiotics.

Glucose load/Hyperglycemia (in Peritoneal Dialysis)

A complication of PD due to dextrose used as a hyperosmolar agent. Management includes IP insulin or switching to icodextrin.