Dialysis/Renal Failure When the Kidneys Term Paper

Download this Term Paper in word format (.doc)

Note: Sample below may appear distorted but all corresponding word document files contain proper formatting

Excerpt from Term Paper:

Physicians, however, prefer hemodialysis because of reimbursement trends (Wellbery).

Dietary Changes - Many patients also prefer peritoneal dialysis to hemodialysis because the latter restricts the diet (NKUDICC 2000). Peritoneal dialysis removes body wastes slowly but it always does. In hemodialysis, on the other hand, wastes can build up for two or three days between treatments. In addition, a patient on hemodialysis must observe a restrictive diet. Some clinics help plan the meals of patients undergoing peritoneal dialysis. Their dietitians can give advice on how to prepare more satisfying meals (NKUDICC).

Management and Implications - Managing acute renal failure begins with determining the cause (Agrawal and Swartz 2000). It includes a thorough history and physical examination, blood tests, urine studies and a renal ultrasound examination. Renal failure warrants supportive therapy to maintain fluid and electrolyte balances, reduce the production of nitrogenous wastes, and to sustain nutrition. Death is most frequently the result of an infection or cardio-respiratory complications. Acute renal failure happens to 5% of hospitalized patients, of whom 0.5% require dialysis. In the last decade, the survival rate has not improved because most patients are now older and have already developed enhancing health conditions. Of the causes of death, infection accounts for 75%. The second most common are cardio-respiratory complications. Their GFR goes down for days and weeks, reducing the excretion of nitrogenous wastes. Fluid and electrolyte balances can no longer be maintained. Most patients suffering from acute renal failure show no symptoms. It is diagnosed only by high levels of blood urea nitrogen or BUN and serum creatinine. Authorities define the condition as an acute increase of the serum creatinine level from baseline. Cephaloxporins and trimethoprim-sulfamethoxazole may also cause acute renal failure by simply inhibiting the tibular secretion of creatinine without damaging the kidneys. The BUN can also increase if a patient receives costicosteroids or if they have increased catabolism or gastrointestinal bleeding (Agrawal and Swartz).

Diagnostic Strategy and Differential - the standard approach is to first eliminate pre-renal and post-renal causes and then examine the potential renal etiologies (Agrawal and Swartz 2000). BUN and serum electrolyte, creatinine, calcium, phosphorus and albumin levels, and a complete blood with differential are all taken. The patient should also undergo the dipstick test, microscopy, sodium and creatinine levels and urine osmolality determination tests (Agrawal and Swartz).

Initial treatment should first correct fluid and electrolyte balances and uremia while the cause of acute renal failure is being determined (Agrawal and Swartz 2000). The patient is resuscitated with saline. Often, however, the problem of volume overload occurs. The first treatment to volume overload is furosemide administered intravenously every six hours at between 20 and 100 mg dose. It can be doubled and repeated. The final resort is ultrafiltration through dialysis. Main electrolyte problems may be hyperkalemia and acidosis. Treatment should be aggressive, depending on the degree of hyperkalamia. Calcium, intravenously administered, can reverse the cardio-protective and temporarily contains the neuromuscular effects of hyperkalemia (Agrawal and Swartz).

Acute renal failure can also render a patient's nutrition deficient (Agrawal and Swartz 2000). His total caloric intake should be between 30 and 45 kcal per kg per day. Most of the intake should cosist of carbohydrates and fats. If he is not on dialysis, his protein intake should be controlled at 0.6 g per kg per day. If he is on dialysis, his protein intake should be 1 to 1.5 g pr kg per day. Lastly, the physician should review all the patient's medications. The dosages should be adjusted according to the GFR, and the serum levels of medication. Records show that 20-60% of patients will need short-term dialysis, especially when the patient's BUN goes over 100 mg per dL and the serum creatinine level goes beyond the 5-10 mg per dL Indications for dialysis include acidosis or electrolyte disturbances. These disturbances do not respond to pharmacologic therapy, fluid overload, which does not respond to diuretics, and uremia. A patient who has progressive acute renal failure should see a nephrologist (Agrawal and Swartz).


Agrawal. M. And Swartz, R. (2000). Acute renal failure. 9 pages. American Family Physicians: American Academy of Family Physicians

Anderson, R.A. (2005). Renal failure: mortality and depression. 2 pages. Townsend Letter for Doctors and Patients: The Townsend Letter Group

Cannon, J.D. (2004). Recognizing chronic renal failure - the sooner, the better. 5 pages. Nursing: Springhouse Corporation

National Kidney and Urologic Diseases Information Clearinghouse Center.…[continue]

Cite This Term Paper:

"Dialysis Renal Failure When The Kidneys" (2007, October 05) Retrieved October 22, 2016, from http://www.paperdue.com/essay/dialysis-renal-failure-when-the-kidneys-35364

"Dialysis Renal Failure When The Kidneys" 05 October 2007. Web.22 October. 2016. <http://www.paperdue.com/essay/dialysis-renal-failure-when-the-kidneys-35364>

"Dialysis Renal Failure When The Kidneys", 05 October 2007, Accessed.22 October. 2016, http://www.paperdue.com/essay/dialysis-renal-failure-when-the-kidneys-35364

Other Documents Pertaining To This Topic

  • Renal Failure

    These clinics will have to be set up over a number of years as funding becomes available for each. It is envisioned that the combination of clinics and learning programs will help the community to achieve better overall health. Indeed, clinics that focus on the specific health issues faced by the Hispanic community will remove some of the burden from general-purpose clinics and hospitals. Conclusion In conclusion, it is projected that

  • Acute Renal Failure Is a Serious Medical

    Acute renal failure is a serious medical condition. The gravity of the condition is manifested itself in the fact that the survival rate for renal failure has not improved for more than forty years. It occurs in 5% of all hospitalized patients and dialysis treatment is required in approximately .5 of cases. Dialysis is required to sustain "fluid and electrolyte balances, minimize nitrogenous waste production and sustain nutrition Infection accounts

  • Kidney Disease Children Although Kidney

    Acute kidney diseases can be severe in the short-term but once treated, the kidney functions return to normal (National Institutes of Health). Hemolytic uremic syndrome and Nephrotic syndrome are acute kidney diseases affecting children. Most acute kidney diseases are caused by trauma, injury, or poisoning. Chronic conditions include deformed kidneys that are due to birth defects, the hereditary disease polycystic kidney disease (PKD), Glomerular diseases, and Systemic diseases (National Institutes

  • Kidney Failure Elke Kidney Failure

    I am not different in this regard; witnessing my sister having gone through the psychological and physiological factors associated with her dialysis treatment, and knowing my own risk, has been illuminating and has given me the impetus to learn about how to deal with the condition. For me, early detection will be key. Patients who have early detection of kidney disease have a better overall prognosis through getting earlier treatment

  • Nursing Kidney Nursing Perceptions and

    (2008). The study measures public opinion concerning two scenarios: one in which the kidney donor is given a fixed financial compensation; and one in which the donor is provided with health insurance coverage for life. According to the findings of the study, "although almost half of the respondents (46%) were reluctant towards introducing a system with fixed compensation to increase the number of living kidney donors, still 25% of

  • Nursing Dialysis Among the Elderly

    Nephrologists are expected to play a role in this determination, but all too often the nephrologist, like other physicians, must be prompted to deal with end-of-life issues. If no one is available to do the prompting, the patient's death may be needlessly prolonged. The amount to which the nephrologist takes on end-of-life care will be reflected in their approach to the patient. At one end of the spectrum, discomfort

  • Impact of Hemodialysis on End Stage Renal Disease Patients

    Hemodialysis on End Stage Renal Disease Patients and the Increasing Role for the Nurse It is a difficult condition of a kidney failure when one's kidney could no longer carry out the proper metabolism system to eliminate waste products. Kidney is the essential organ that is responsible in waste elimination, including others like detoxification process of drugs and toxic materials, also in controlling water balance, salt balance, blood pressures and

Read Full Term Paper
Copyright 2016 . All Rights Reserved