Indications for Dialysis

The decision to initiate dialysis or hemofiltration in patients with renal failure depends on several factors. These can be divided into acute or chronic indications.

• Indications for dialysis in the patient with acute kidney injury are:
  1. Metabolic acidosis in situations where correction with sodium bicarbonate is impractical or may result in fluid overload.
  2. Electrolyte abnormality, such as severe hyperkalemia, especially when combined with AKI.
  3. Intoxication, that is, acute poisoning with a dialysable drug, such as lithium, or aspirin.
  4. Fluid overload not expected to respond to treatment with diuretics.
  5. Complications of uremia, such as pericarditis, encephalopathy, or gastrointestinal bleeding.
  6. Chronic indications for dialysis:
     1. Symptomatic renal failure
     2. Low glomerular filtration rate (GFR) (RRT often recommended to commence at a GFR of less than 10-15 mls/min/1.73m²). In diabetics dialysis is started earlier.
     3. Difficulty in medically controlling fluid overload, serum potassium, and/or serum phosphorus when the GFR is very low

Further Reading

• What is Dialysis?
• Dialysis Types

This article is licensed under the Creative Commons Attribution-ShareAlike License. It uses material from the Wikipedia article on "Dialysis" All material adapted used from Wikipedia is available under the terms of the Creative Commons Attribution-ShareAlike License. Wikipedia® itself is a registered trademark of the Wikimedia Foundation, Inc.