Indications for hemodialysis
Acute kidney injury
Intoxication
Overhydration (ultrafiltration)
Acute kidney injury (AKI): indications for hemodialysis
01
Oliguria/anuria
02
Uncontrolled clinical signs
03
Severe hyperkalemia
04
Severe fluid overload
05
Progressive azotemia
06
Severe acid-base disturbance
Prognosis of AKI
Toxic injury
Variable prognosis
Infectious causes
Favorable
Ischemia
Favorable
Survival of AKI
The survival associated with AKI is extremely variable.
Factors associated with a lower likelihood of survival includes
-
Lower body weight
-
Anemia
-
Low lymphocyte count
-
Higher creatinine
-
Higher phosphorus level
-
Lower ionized calcium
-
Higher anion gap
-
Increased ALT
-
Lower urine production
-
Increased respiratory rate
-
Presence of neurologic signs
-
Presence of DIC
-
Ethylene glycol toxicity
54%
48%
Important facts
-
Hemodialysis is non-invasive and non-painful
-
Clinical signs improve significantly during hemodialysis
-
Goal of hemodialysis is to provide kidney support while waiting for kidneys to recover
-
Best patient care