Fluid and Electrolyte Balance in Dialysis Flashcards

How is Kt/V used in hemodialysis?

Answer: Quantifies the adequacy of urea removal during dialysis

Kt/V is the primary measure of hemodialysis adequacy, representing the fraction of patient's total body water cleared of urea per treatment.

Secondary hyperparathyroidism in ESRD patients is primarily driven by which combination of factors?

Answer: Hyperphosphatemia, hypocalcemia, and low active vitamin D

The kidneys' inability to activate vitamin D and excrete phosphorus leads to hyperphosphatemia and hypocalcemia, driving excess PTH secretion.

A patient's post-dialysis BUN is 30 mg/dL and pre-dialysis BUN was 90 mg/dL. What is the URR?

Answer: 67%

URR = (pre-BUN − post-BUN) / pre-BUN × 100 = (90 − 30) / 90 × 100 = 67%, which meets the minimum recommended 65% target.

Which type of dialysate concentrate contains the electrolytes and glucose for hemodialysis?

Answer: Acid concentrate (Part A)

The acid concentrate (Part A) contains sodium, potassium, calcium, magnesium, glucose, and acetic or citric acid to prevent calcium precipitation.

A dialysis patient with chronic fluid overload develops worsening left ventricular hypertrophy. What is the primary modifiable contributing factor?

Answer: Persistent fluid overload and hypertension

Chronic fluid overload causes sustained hypertension and increased cardiac preload, driving left ventricular hypertrophy and heart failure in dialysis patients.

A patient on CAPD exchanges 2 L of 2.5% dextrose dialysate four times daily. What does the higher dextrose concentration indicate compared to 1.5%?

Answer: Greater osmotic gradient for enhanced ultrafiltration

Higher dextrose concentrations create a stronger osmotic gradient across the peritoneal membrane, increasing ultrafiltration to remove more fluid.