Infection. Inadequate dialysis.

Infection

High Potassium - In medical terms, this is known as hyperkalaemia. This means that there is too much potassium in the blood. This can be dangerous and life-threatening. High potassium can affect the muscles of the body including the heart, which could stop beating. By sticking to the diet, that the dietician has prescribed for you, you can avoid this serious complicationl.

2. Peritoneal dialysis complications: - Infections - An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis.

Weight gain - The dialysate contains sugar (dextrose).

Hernia - holding fluid in your abdomen for long periods may strain your muscles.

Inadequate dialysis.

Mechanical – pain, perforation, blood in dialysate, early dialysate leakage, respiratory insufficiency, extravasation of fluid in tissue compartments, hydrothorax.

Medical – fluid, electrolyte and acid base disturbances, hypovolemia and hypervolemia, hypoalbuminemia.

3. CRRT complications: - Hemodynamic disturbances - are dominated by hypotension due to the modification of volume status, myocardial dysfunction, cardiac arrhythmia, or modification of systemic vascular resistances, which are correlated with body temperature changes. Metabolic complications - remain at the forefront and have profoundly changed with the use of regional citrate anticoagulation (RCA). RCA may lead to two distinct situations: citrate overload and citrate accumulation, respectively, responsible for metabolic alkalosis and metabolic acidosis. Electrolyte imbalance is also a classic occurrence with RCA. The chelation of cations by citrate results in hypocalcemia and hypomagnesemia in case of inappropriate substitution.

CONCLUSION:

Dialysis is an imperfect treatment to replace kidney function because it does not correct the compromised endocrine functions of the kidney. Dialysis treatments replace some of these functions through diffusion (waste removal) and ultrafiltration (fluid removal). Based on the overall evidence from the assessment of the clinical effectiveness, cost-effectiveness, patient experiences and perspectives, ethical issues, and implementation issues, home-based dialysis (HHD and PD) are appropriate modality options for the treatment of ESKD and could be more widely implemented in Canadian jurisdictions.

Hemodialysis results If you had sudden (acute) kidney injury, you may need hemodialysis only for a short time until your kidneys recover. If you had reduced kidney function before a sudden injury to your kidneys, the chances of full recovery back to independence from hemodialysis are lessened. Although in-center, three-times-a-week hemodialysis is more common, some research suggests that home dialysis is linked to: Better quality of life, Increased well-being, Reduced symptoms and less cramping, headaches and shortness of breath, improved appetite, sleeping patterns, energy level and ability to concentrate.

Peritoneal dialysis has been in use since 1970 in patients with acute kidney injury especially those who are hemodynamically unstable or at risk of bleeding because of bleeding tendency, in pediatric patients with acute kidney injury, and in patients with vascular access failure. Peritoneal dialysis remains an effective therapy which is simple and easy to use. This is especially the case for infants and children with AKI both in ICU and non-ICU settings, although its use is less preferable in western countries especially with advent of newer options available for CRRT like SLED and CVVDHF. It is a less effective modality in certain clinical situations like patients with poisoning, hypercatabolic states, and pulmonary edema. There is a limited data concerning the effect on mortality of PD versus other RRT therapies like intermittent hemodialysis and other continuous renal replacement therapies in patients with acute kidney injury.

CRRT is an effective treatment for the haemodynamically unstable child with AKI. There was no difference in mortality between the group of children above and below 10 kg. In this study, mortality was lower in children than in adults with CRRT-treated AKI. In comparison with adults, fewer children regained kidney function.

REFERENCES:

1. Content written on May 11, 2020 and updated on June 3, 2020 – Medically reviewed by Frances E. Ashe-Goins, RN, MPH, FAAN, Orlando Gutierrez, MD

2. Medically reviewed by Alana Biggers, M. D., MPH — Written by Yvette Brazier on July 17, 2018

3. R. Noel Gibney. Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

4. Karkar A. Continuous renal replacement therapy: Principles, modalities, and prescription. Saudi J Kidney Dis Transpl 2019; 30: 1201-9

5. August 1, 2012. By: Neal Shah, Co-Editor-in-Chief. St. John’s University College of pharmacy and health sciences.

6. Murdeshwar HN, Anjum F. Hemodialysis. [Updated 2020, Dec 4].

7. Bagshaw SM, Berthiaume LR, Delaney A, Bellomo R: Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: a meta-analysis. Crit Care Med 2008; 36: 610-617.

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