Discover and read the best of Twitter Threads about #dialysisdirector
Most recents (10)
Infographic and FAQ sheet with Information for Screening and Management of COVID-19 in the Outpatient Dialysis Facility from @ASNKidney
#nCoV2019 #COVID19 #COVID2019 #DialysisDirector
👉🏼 Infographic asn-online.org/g/blast/files/…
👉🏼 FAQ asn-online.org/g/blast/files/…
#nCoV2019 #COVID19 #COVID2019 #DialysisDirector
👉🏼 Infographic asn-online.org/g/blast/files/…
👉🏼 FAQ asn-online.org/g/blast/files/…
The Novel Coronavirus 2019 Epidemic and Kidneys ca. 2020 from @Kidney_Int @vjha126
“Postulated” mechanisms:
👉🏼 Sepsis leading to cytokine storm syndrome
👉🏼 Direct cellular injury due to the virus
#nCoV19 #nCoV2019 #COVID2019 #COVID19 #Nephpearls
👉🏼 kidney-international.org/article/S0085-…
“Postulated” mechanisms:
👉🏼 Sepsis leading to cytokine storm syndrome
👉🏼 Direct cellular injury due to the virus
#nCoV19 #nCoV2019 #COVID2019 #COVID19 #Nephpearls
👉🏼 kidney-international.org/article/S0085-…
Therapeutic Apheresis 101
📌 Extracorporeal procedures whereby blood separation technology is used to remove abnormal blood cells and/or plasma constituents
🔲 Plasmamapheresis
🔲 Leukapheresis
🔲 Erythrocytapheresis
🔲 Thrombocytapheresis
#Nephpearls #DialysisDirector
📌 Extracorporeal procedures whereby blood separation technology is used to remove abnormal blood cells and/or plasma constituents
🔲 Plasmamapheresis
🔲 Leukapheresis
🔲 Erythrocytapheresis
🔲 Thrombocytapheresis
#Nephpearls #DialysisDirector
In plasmapheresis, or therapeutic plasma exchange (TPE), large quantities of plasma are removed from a patient and replaced with
👉🏼 Fresh frozen plasma (FFP), or
👉🏼 Albumin solutions in normal saline
#Nephpearls #DialysisDirector
👉🏼 Fresh frozen plasma (FFP), or
👉🏼 Albumin solutions in normal saline
#Nephpearls #DialysisDirector
Evolution of CRRT ca. 2006 from @croncoIRRIV #Nephpearls #DialysisDirector
👉🏼 ccforum.biomedcentral.com/track/pdf/10.1…
👉🏼 ccforum.biomedcentral.com/track/pdf/10.1…
CVVHD
📌 Dialysate is passed through the dialysate compartment of the filter continuously and at a slow rate
📌 Diffusion is the primary method of solute removal
📌 Fluid removal: Usually about 3–6 L per day
#Nephpearls #DialysisDirector
📌 Dialysate is passed through the dialysate compartment of the filter continuously and at a slow rate
📌 Diffusion is the primary method of solute removal
📌 Fluid removal: Usually about 3–6 L per day
#Nephpearls #DialysisDirector
Hemodialysis 101: Anticoagulation
📌 Factors favoring clotting of the extracorporeal circuit
#Nephpearls #DialysisDirector
📌 Factors favoring clotting of the extracorporeal circuit
#Nephpearls #DialysisDirector
Hemodialysis 101: Anticoagulation
📌 Signs of clotting in the extracorporeal circuit
#Nephpearls #DialysisDirector
📌 Signs of clotting in the extracorporeal circuit
#Nephpearls #DialysisDirector
Anticoagulation options for intermittent hemodialysis ca. 2011 from @NatRevNeph #Nephpearls #DialysisDirector
👉🏼 nature.com/articles/nrnep…
👉🏼 nature.com/articles/nrnep…
Hemodialysis 101: Complications
📌 Intradialytic Hypotension
📌 Muscle Cramps
📌 Nausea and Vomiting
📌 Pruritus
📌 Dysequilibrium Syndrome
📌 Dialyzer Reactions
📌 Hemolysis
📌 Air Embolism
#Nephpearls #DialysisDirector
📌 Intradialytic Hypotension
📌 Muscle Cramps
📌 Nausea and Vomiting
📌 Pruritus
📌 Dysequilibrium Syndrome
📌 Dialyzer Reactions
📌 Hemolysis
📌 Air Embolism
#Nephpearls #DialysisDirector
Intradialytic Hypotension (IDH): Nadir SBP < 90 👉🏼 strongest association with ⬆️ mortality
📌 Poor long-term Outcomes
📌 ⬆️ mortality
📌 Myocardial stunning
📌 Incidence is highest in those with low pre-HD BP
📌 ⬆️ risk of access thrombosis
#Nephpearls #DialysisDirector
📌 Poor long-term Outcomes
📌 ⬆️ mortality
📌 Myocardial stunning
📌 Incidence is highest in those with low pre-HD BP
📌 ⬆️ risk of access thrombosis
#Nephpearls #DialysisDirector
Intradialytic Hypotension (IDH): Strategies to help prevent Hypotension during dialysis #Nephpearls #DialysisDirector
HD Catheters: Nominal flow > 400 mL/min (actual flow 350 mL/min) can rarely be obtained and usually flow is limited to a range closer to 300 mL/min
#Nephpearls #DialysisDirector
#Nephpearls #DialysisDirector
HD Catheters: Order of preference for various sites of insertion
📌 Optimal site is R IJ since venous pathway to the RA is relatively short and straight
📌 Avoid SC Vein due to ⬆️ rate of insertion related complications
📌 L IJ is not optimal
#Nephpearls #DialysisDirector
📌 Optimal site is R IJ since venous pathway to the RA is relatively short and straight
📌 Avoid SC Vein due to ⬆️ rate of insertion related complications
📌 L IJ is not optimal
#Nephpearls #DialysisDirector
Urgent Start PD: Defining what it is and why it matters ca. 2018 from @CJASN #Nephpearls
👉🏼 cjasn.asnjournals.org/content/clinja…
👉🏼 cjasn.asnjournals.org/content/clinja…
Despite the adverse scenario for initiating dialysis, early start PD had similar outcomes in comparison to planned-start PD in long-term follow-up ca. 2018 #Nephpearls
👉🏼 karger.com/Article/FullTe…
👉🏼 karger.com/Article/FullTe…
Urgent start PD: Modality of choice - manual or automated ca. 2019 from @CKJsocial #Nephpearls
👉🏼 academic.oup.com/ckj/article/12…
👉🏼 academic.oup.com/ckj/article/12…
Hemodialysis 101: Water and Dialysate
📌 During HD, patients are exposed to 120-200 L of dialysis solution during each dialysis treatment
#Nephpearls #DialysisDirector
📌 During HD, patients are exposed to 120-200 L of dialysis solution during each dialysis treatment
#Nephpearls #DialysisDirector
Water contaminants that are toxic to patients on dialysis
#Nephpearls #DialysisDirector
👉🏼 cjasn.asnjournals.org/content/clinja…
#Nephpearls #DialysisDirector
👉🏼 cjasn.asnjournals.org/content/clinja…
Methods of purifying water for hemodialysis
#Nephpearls #DialysisDirector
👉🏼 cjasn.asnjournals.org/content/clinja…
#Nephpearls #DialysisDirector
👉🏼 cjasn.asnjournals.org/content/clinja…
Hemodialysis 101: Apparatus
📌 From the patient, blood is pumped via the vascular access thru an ARTERIAL blood line (INFLOW) to the dialyzer
📌 Blood is returned to the patient from the dialyzer via a VENOUS blood line (OUTFLOW)
#Nephpearls #DialysisDirector
📌 From the patient, blood is pumped via the vascular access thru an ARTERIAL blood line (INFLOW) to the dialyzer
📌 Blood is returned to the patient from the dialyzer via a VENOUS blood line (OUTFLOW)
#Nephpearls #DialysisDirector
Redsense sensor is used to detect blood leakage at the site of potential line separation
📌 For those who are at high risk for line separation
#Nephpearls #DialysisDirector
👉🏼 redsensemedical.com/index.php/cont…
📌 For those who are at high risk for line separation
#Nephpearls #DialysisDirector
👉🏼 redsensemedical.com/index.php/cont…
The VENOUS PRESSURE can be used to monitor the state of coagulation.
It is a function of:
📌 BFR
📌 Blood viscosity
📌 Downstream access (needle or catheter) resistance
#Nephpearls #DialysisDirector
It is a function of:
📌 BFR
📌 Blood viscosity
📌 Downstream access (needle or catheter) resistance
#Nephpearls #DialysisDirector
