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What is dialysis?
Helps to remove extra fluid and waste products from blood
Keep safe levels of minerals - K+, NA+, Ca, CO3
Regulates bp
2 types: hemodialysis and peritoneal
How does hemodialysis work?
Dialyzer removes waste and extra fluid
Filtered blood goes back into body
Mainly done at a centre
Takes 4 hours and done 3x a week
Vascular access site surgery is done to open up blood vessel

What are the side effects for hemodialysis?
Blockage in vascular access site
Muscle cramps
Hypotension
Blood loss
Weak, dizzy, nausea
Infection of the skin, blood, and/or peritoneum
Fatigue
Pruritus (itchy skin)
How does peritoneal dialysis work?
Blood is filtered inside the body
Belly is slowly filled with dialysate (cleansing fluid) through a catheter (minor surgery to place)
Peritoneum is used as a filter
Extra fluid and waste products are pulled out of blood vessels
Fluid is drained after a couple hours
Mainly done at home
2 types: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD)
What are the side effects of peritoneal dialysis?
Hernia
Weight gain
Infection of the skin, blood, and/or peritoneum
Fatigue
Pruritus (itchy skin)
What can be done to ↑ dialysis effectiveness?
Complete treatments with schedule
Follow eating plan
↑ physical activity to boost strength and heart health
Talk with provider and pharmacist about meds, supplements or herbal products
Table with team about concerns and side effects
What is EPO?
Hormone that signals bone marrow to ↑ RBC production
Naturally made in kidneys
Injection to treat anaemia and those with CKD too
Athletes can use to ↑ performance
What are the formulation issues when producing and supplying EPO?
Susceptible to degradation
Hypo/hypertonicity of drug
Buffer?
Stability
Store in fridge
Don't shake
What should be monitored for patients who are anaemic and getting dialysis?
Blood pressure
Red
Reticulocyte counts - immature RBC
Hb
Electrolytes
Iron or folate deficiency - correct before treatment