12) Renal Replacement Therapy

What eGFR value typically defines the onset of end-stage renal failure?

Less than 15 mL/min

Which of the following is dialysis LEAST effective at managing?

Anaemia

Which hormone must be replaced in dialysis patients to manage anaemia?

Erythropoietin

Which solutes are MOST effectively cleared by dialysis?

Low molecular weight solutes

Which of the following is NOT typically well regulated by dialysis?

Vitamin D activation

Which type of dialysis is commonly done at home and involves infusing fluid into the abdomen?

Peritoneal dialysis

Which of the following is a contraindication to peritoneal dialysis?

Abdominal adhesions from previous surgery

What complication is most associated with high volumes of dialysate in the abdomen?

Respiratory compromise in lung disease

What is the typical vascular access used for haemodialysis in stable patients?

Arteriovenous (AV) fistula

Which of the following best describes the AV fistula used in haemodialysis?

A surgical connection between a vein and an artery

Which of the following situations is dialysis MOST urgently indicated?

Hyperkalaemia with ECG changes

What is the first emergency drug given to stabilise the cardiac membrane in severe hyperkalaemia?

Calcium chloride

How does insulin help treat hyperkalaemia?

Drives potassium into cells

Why is glucose co-administered with insulin in hyperkalaemia treatment?

To prevent hypoglycaemia

What common asthma medication is used to help lower potassium in emergencies?

Salbutamol

In an emergency setting, haemodiafiltration is most commonly used for:

Critically ill patients in ICU

What does the mnemonic AEIOU (Acidosis / Electrolytes - refractory hyperkalemia, Intoxications / Overload with fluid refractory to diuresis / Uremic pericarditis, uremic encephalopathy) help identify?

Indications for starting haemodialysis

Which drug toxicity can be treated using dialysis?

Lithium

Which of the following is NOT a uraemic complication that can indicate urgent dialysis?

Hypercalcaemia

In dialysis, which of the following most accurately describes the principle of solute removal?

Passive diffusion and osmosis across a semi-permeable membrane