Indications of dialysis in acute renal failure (ARF)
- Severe fluid overload
- Refractory hypertension
- Uncontrollable hyperkalemia
- Nausea, vomiting, poor appetite, gastritis with hemorrhage
- Lethargy, malaise, somnolence, stupor, coma, delirium, asterixis, tremor, seizures,
- Pericarditis (risk of hemorrhage or tamponade)
- bleeding diathesis (epistaxis, gastrointestinal (GI) bleeding, etc.)
- Severe metabolic acidosis
- Blood urea nitrogen (BUN) > 70 – 100 mg/dl
Indications of dialysis in chronic renal failure (CRF)
- Pericarditis
- Fluid overload or pulmonary edema refractory to diuretics
- Accelerated hypertension poorly responsive to antihypertensives
- Progressive uremic encephalopathy or neuropathy such as confusion, asterixis, myoclonus, wrist or foot drop, seizures
- Bleeding diathesis attributable to uremia
References:
- Hemodialysis Adequacy 2006 Work Group. KDOQI Clinical Practice Guidelines for Hemodialysis Adequacy, Update 2006. Am J Kidney Dis 2006; 48(Suppl 1):S2-90.[Medline]
- Pannu N, Klarenbach S, Wiebe N, Manns B, Tonelli M; Alberta Kidney Disease Network. Renal replacement therapy in patients with acute renal failure: a systematic review. JAMA. 2008 Feb 20;299(7):793-805.[Medline]
Created:Jun 19, 2009
