Would you recommend adjusting the hemodialysis schedule for a TTS dialysis patient who is scheduled for surgery on a Monday?
Would you recommend adjusting the hemodialysis schedule for a TTS dialysis patient who is scheduled for surgery on a Monday?
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It depends on the patient. If the patient has no residual renal function, it’s prone to volume overload or hyperkalemia; such a patient would benefit from a dialysis session on Monday before surgery. If the patient is recently initiated on iHD, or has good volume control and electrolytes are fine, y...
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There is a significant chance the surgery would be cancelled for hyperkalemia. So, yes, I would definitely try to do dialysis prior to surgery, as close to it as possible.
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Avoid hypertension, fluid overload, excessive bleeding, and hyperkalemia by doing dialysis preceding surgery.
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It absolutely makes sense to metabolically optimize conditions for surgery, plus or minus volume, to mitigate the risk of complications in a patient with ESRD.
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