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Dialysis PowerPoint Presentation by Ibrahim Alhassan

Renal Replacement Therapies

  • The use of renal replacement therapies becomes necessary when the kidneys can no longer
    • Remove wastes
    • Maintain electrolytes and regulate fluid balance.
  • This can occur rapidly or over a long period of time and the need for replacement therapy can be acute (short term) or chronic (long term).
  • The main renal replacement therapies include the various types of dialysis and kidney transplantation.


  • When a patient is in late stage chronic kidney disease (stage 4) or facing kidney failure (stage 5, end stage renal disease) he/she is referred to a dialysis and transplantation centre for kidney replacement therapy.
  • It is usually initiated when the patient cannot maintain a reasonable lifestyle with conservative treatment.
  • Types of dialysis include hemodialysis, CRRT, and Peritoneal dialysis.
  • Acute dialysis is indicated when there is a high and increasing level of serum potassium, fluid overload, or impending pulmonary edema, increasing acidosis, pericarditis, and severe confusion. 
  • It may also be used to remove medications or toxins (poisoning or medication overdose) from the blood.
  • Chronic or maintenance dialysis is indicated in advanced CKD and ESRD in the following instances: the presence of uremic signs and symptoms affecting all body systems, hyperkalemia, fluid overload not responsive to diuretics.
  • The decision to initiate dialysis should be reached only after thoughtful discussion among the patient, family, physician, and others as appropriate.

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