Indications for Dialysis

By Dr Ananya Mandal, MD

Dialysis is a life saving process. The decision to carry out dialysis may be made in the case of either chronic or acute illness.

Acute or sudden illness

Examples of acute conditions where dialysis may be used include:

Metabolic acidosis or a change of the blood pH to acidic. Usually, this condition can be treated by neutralizing the acidic blood with sodium bicarbonate. However, dialysis may be needed in cases where this is impractical or if there is a risk of fluid overload.

Electrolyte imbalance such as severe hyperkalemia where the blood level of potassium is raised.

Overload of fluid in the body that diuretics cannot relieve.

Acute poisoning where the harmful substance can be removed by dialysis. Lithium, a drug used to treat mood disorders and the pain reliever aspirin are two examples of drugs that can be removed using dialysis

Uremia - Certain complications of the condition uremia where urea and other waste material builds up in the blood. Such complications include pericarditis (inflammation of the pericardium in the heart), encephalopathy or a disease affecting brain function and gastrointestinal tract bleeding.

Chronic or long-term illness

  • Renal failure where symptoms are manifesting
  • In the case of a lowered glomerular filtration rate (GFR) that has dropped to less than 10-15 mls/min/1.73m2, although in diabetics dialysis is started before this stage is reached.
  • In cases of low GFR where medication is unable to control fluid overload and rising levels of serum potassium or phosphorus.

Reviewed by Sally Robertson, BSc

Sources

  1. http://www.mcw.edu/FileLibrary/User/kerbach/Dialysis.pdf
  2. http://www.nhs.uk/Conditions/dialysis/Pages/Introduction.aspx
  3. http://www.gosh.nhs.uk/medical-conditions/procedures-and-treatments/dialysis-an-introduction-to-dialysis/
  4. http://www.kidney.org/atoz/pdf/peritonealdialysis.pdf
  5. http://lifeoptions.org/catalog/pdfs/booklets/exercise.pdf
  6. http://www.nlm.nih.gov/medlineplus/dialysis.html

Further Reading

Last Updated: Jan 14, 2014

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