References

Acierno MJ Continuous renal replacement therapy in dogs and cats. Vet Clin North Am Small Anim Pract. 2011; 41:(1)135-46 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.09.001

Bloom CA, Labato MA Intermittent haemodialysis for small animals. Vet Clin North Am Small Anim Pract. 2011; 41:(1)115-33 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.11.001

Cooper RL, Labato MA Peritoneal dialysis in veterinary medicine. Vet Clin North Am Small Anim Pract. 2011; 41:(1)91-113 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.10.002

Chalhoub S, Langston CE, Poeppel K Vascular access for extracorporeal renal replacement therapy in veterinary patients. Vet Clin North Am Small Anim Pract. 2011; 41:(1)147-161 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.09.007

Elliott DA Nutritional considerations for the dialytic patient. Vet Clin North Am Small Anim Pract. 2011; 41:(1)239-250 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.10.001

Joint United Kingdom Blood Transfusion and Tissue Transplantation and Services Professional Advisory Committee. Therapeutic Plasma Exchange (TPE) [Internet]. 2014. http://tinyurl.com/ybxt5edv

Renal replacement therapy in the intensive care unit [Internet]. 2005. http://tinyurl.com/yak87dxd

Ross S Anticoagulation in intermittent hemodialysis: pathways, protocols and pitfalls. Vet Clin North Am Small Anim Pract. 2011; 41:(1)163-75 https://doi.org/https://doi.org/10.1016/j.cvsm.2010.12.001

Haemodialysis: techniques, anticoagulation and nursing

02 December 2017

Clinical

9 mins read

02 December 2017

Volume 8 · Issue 10

ISSN (print): 2044-0065

ISSN (online): 2052-2959

Abstract

The term ‘dialysis’ is used frequently to describe several different techniques. Intermittent haemodialysis, continuous renal replacement therapy, therapeutic plasma exchange and peritoneal dialysis all effectively remove unwanted substances from a patient's bloodstream. This article discusses these techniques, their indications in practice and the use of both unfractionated heparin and citrate as anticoagulants during these processes. The extensive nursing care and nutritional requirements of these patients will also be discussed.

Common indications for dialysis include acute kidney injury (AKI), chronic kidney disease (CKD) and toxin ingestion (Bloom and Labato, 2011). In the USA, haemodialysis is regularly used to treat patients with CKD; however in the UK, haemodialysis is only available for treatment of patients with AKI and toxin ingestion.

Bloom and Labato (2011) describe the indications for haemodialysis in patients suffering with CKD, including hyperkalaemia, fluid overload and progressive azotaemia. Haemodialysis is also used prior to renal transplantation in the USA — a procedure not carried out in the UK. Bloom and Labato (2011) further described indications for haemodialysis in patients with AKI including persistent azotaemia, electrolyte abnormalities, acidosis and oliguria/anuria despite treatment with appropriate medical management.

Intermittent haemodialysis (IHD) was first carried out in the early 1900s when a pharmacologist experimented by passing arterial blood from animal patients through an array of semi-permeable membranes suspended in a fluid solution, before returning the blood to the patient. The composition of the patient's blood was altered by changing the solute in which the semi-permeable membranes were fixed (Acierno, 2011). Today, IHD is commonly carried out for patients with AKI, CKD and toxin ingestion by universities and specialist veterinary referral centres (Figures 1 and 2) (Bloom and Labato, 2011).

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.

Or continue by

Signing in with your registered email address