Category:

Basic Clinical Dialysis

Course Outline

“The extensive provision of clinical protocols for management of common dialysis management problems will be particularly invaluable for all staff involved in the care of the patient with renal disease.” — Dr. Paul Snelling, President, Australian and New Zealand Society of Nephrology

Basic Clinical Dialysis presents comprehensive, concise information on the clinical care and management of chronic kidney disease through dialysis treatment. The authors have adopted a highly practical approach to presenting the basic principles of patient management, distilling important information into easy-to-read lists and tables. Management protocols are clearly highlighted throughout to provide step-by-step guidelines for patient care.

This handy, quick reference guide is ideal for medical students, resident medical officers, junior advanced trainees in nephrology, nurses and paramedical staff. The book was written by special practitioners in the field and edited by Australia’s leading nephrologists, from Westmead Hospital and the Sydney West Area Health Services, Australia.

Key Features:

  • Highly accessible, east-to-understand style and format
  • Written for the Australian market with reference to local protocols and practices
  • Tables and illustrations throughout

About Authors

Mario Skugor, MD is Professor in the Department of Medicine of the University of Sydney, at Westmead Hospital.

Lucas Kairaitis, MD is a staff specialist nephrologist at Westmead Hospital.

Gopala Rangan, MD is a staff specialist in Renal Medicine at Westmead Hospital and Area Health Services.

Graham Elder, MD is a staff specialist in Renal Medicine at Westmead Hospital.

Learning Objectives

After completing this course you’ll be able to:

  1. Discuss CKD.
  2. Describe urinary sediment of the acute and advanced renal patient.
  3. List major causes of apparent failure of dialysis.
  4. State the aims of predialysis education.
  5. Compare home dialysis and a satellite program.
  6. State when dialysis should be started.
  7. State the two reasons for opting for conservative advanced CKD treatment.
  8. Discuss the statistics of deaths in dialysis and post-transplantation.
  9. Discuss the hematinic deficiency and how it is corrected.
  10. Discuss heparin-induced thrombocytopenia and complications.
  11. Describe how to manage acute bleeding in patients on dialysis.
  12. State why lepirudin should not be used to reverse the effects of heparin.
  13. List the role of the parathyroid hormone.
  14. Define osteomalacia and list the clinical features.
  15. Describe osteoporosis.
  16. Describe a low dose DFO challenge, according to Protocol 2.4 C.
  17. List the indications of a parathyroidectomy and benefits that may be incurred.
  18. List the recommended vaccinations for patients on dialysis.
  19. Discuss associated management statements for the pregnant woman.
  20. Discuss the use of magnesium for seizure prophylaxis in the woman with pre-eclampsia.
  21. Compare the “beating heart donor” and the “non-beating heart donor”.
  22. Discuss live donor transplantation.
  23. Compare drugs poorly removed by dialysis and those effectively removed by dialysis.
  24. Discuss the need for dietary potassium in the hemodialysis and peritoneal dialysis patient.
  25. Define convection and diffusion.
  26. Define porosity and absorption.
  27. Define high-efficiency membranes.
  28. List impurities that should be removed from the water for dialysis.
  29. List most effective and less effective methods of delivering a dialysis dose.
  30. State the indications for tunneled and non-tunneled hemodialysis catheters.
  31. List complications of hemodialysis catheters.
  32. State the two most common types of arteriovenous fistulas.
  33. Compare the AV fistula and the AV graft according to Table 3.4.
  34. Define arterial steal syndrome.
  35. Describe briefly the complications during hemodialysis.
  36. State the advantages of peritoneal dialysis.
  37. State the disadvantages of peritoneal dialysis.
  38. Describe normal anatomy of the peritoneal cavity.
  39. Compare substances lost in the dialysate and absorbed into the circulation during peritoneal dialysis.
  40. State the placement of the peritoneal dialysis catheter.
  41. Discuss chronic care of the peritoneal dialysis catheter.
  42. Describe the dextrose-containing peritoneal dialysis solution.
  43. Describe the peritoneal dialysis cycle.
  44. Compare continuous ambulatory peritoneal dialysis and automated peritoneal dialysis.
  45. Discuss residual renal function.
  46. Describe the various types of contamination of the perineum.
  47. Discuss symptoms and management for fluid overload, volume depletion and metabolic abnormalities.
  48. List management techniques for constipation.
  49. Describe nutritional complications for children receiving peritoneal dialysis.
  50. List complications of acute renal failure and the treatment that may be required prior to dialysis.
  51. Describe the three extracorporeal modalities for acute poisoning.
  52. Define apheresis and plasmapheresis.

Course Contents

Part 1: Introduction

1.1 Normal kidney function
1.2 Stages of chronic kidney disease
1.3 Assessment of the patient with chronic kidney disease
1.4 Limitations of dialysis as replacement for normal kidney function
1.5 Preparation of the patient for maintenance dialysis
1.6 Conservative therapy for advanced chronic kidney disease

Part 2: General care of patients with chronic kidney disease

2.1 Cardiovascular risk management
2.2 Erythropoiesis
2.3 Bleeding and thrombosis
2.4 Parathyroid hormone, vitamin D, calcium, phosphate and bones
2.5 Endocrine disturbances of chronic kidney disease
2.6 Infection control
2.7 Pregnancy and dialysis
2.8 Preparation for transplantation
2.9 Drug prescription to dialysis patients
2.10 Nutrition
2.11 Routine surveillance of dialysis patients

Part 3: Haemodialysis

3.1 Haemodialysis physiology
3.2 Haemodialysis equipment
3.3 Haemodialysis adequacy and prescription
3.4 Vascular access for haemodialysis
3.5 Anticoagulation for haemodialysis
3.6 The first haemodialysis treatment
3.7 Complications during haemodialysis
3.8 Haemodialysis in children

Part 4: Chronic peritoneal dialysis

4.1 General principles
4.2 Peritoneal membrane physiology
4.3 Peritoneal dialysis access and complications
4.4 Peritoneal dialysis training and education
4.5 Peritoneal dialysis solutions and connection systems
4.6 Methods of chronic peritoneal dialysis
4.7 Prescribing and modifying chronic peritoneal dialysis
4.8 Peritonitis and exit-site infections
4.9 Medical complications of chronic peritoneal dialysis
4.10 Peritoneal dialysis in children

Part 5: Acute dialysis

5.1 Dialysis in acute renal failure
5.2 Extracorporeal therapy for acute poisoning
5.3 Plasmapheresis