Hyperkalemia or elevated serum potassium is defined as serum potassium level above 5.5 mill equivalents perliter . Hyperkalemia is medical emergency as it can lead to cardiac arrest and death if not diagnosed early and treated properly . Many causes can lead to hyperkalemia but kidneys failure is the most common cause as the kidneys are responsible for excretion excess potassium from the body . Dialysis is a type of treatment that replace many of the kidney’s function .
Aim of work : to define effectiveness of dialysis in hyperkalemia patient with chronic renal failure
Method : I search on net mainly on Cochranea and Pubmed databases were Meta-analysis, randomized controlled trials and case control studies were recommended dialysis in chronic renal failure .
Results : Different studies as Meta-analysis, randomized controlled trials and case control show different agents are used to lower potassium serum level as Loop diuretics, intravenous sodium bicarbonate, intravenous Regular insulin and glucose, Beta-adrenergic agents and Sodium polystyrene sulfate and the importance of dialysis in life saving of patients with sever hyperkalemia to medical therapy particularly patients with chronic renal failure as their kidneys do not respond to treatment, and adequate kidney function does not return. Dialysis can be by accessing the blood vessels through the skin (hemodialysis) or by accessing the abdominal cavity through the lining that encases the abdominal organs (peritoneal dialysis). In chronic renal failure patient who have do dialysis frequently choosing between hemodialysis or peritoneal dialysis is based on lifestyle, other medical conditions, and body size and shape but in patients who have widely fluctuating blood pressure when they receive hemodialysis ,they may be switched to peritoneal dialysis. Complications of dialysis can be Hypotension, muscle cramps ,Disequilibrium Syndrome, chest pain , nausea , vomiting , headache, itching, Fever and Chills and pyrogenic reactions clotting , Blood leak, Hemolysis, Exsanguination, air embolism and Dialyzer reactions although most complications can be prevented or easily managed if monitored carefully during each dialysis session.
Conclusion: evidence support and yes I will recommend dialysis in this child who suffering from chronic renal failure with hyperkalemia . Dialysis remains theprocedure of choice in life threatening hyperkalemia unresponsive to medical therapy and in cases where kidney function is poor.
Keywords: hyperkalemia, chronic renal failure , dialysis , cardiovascular disease, emergency medications
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