Authors: Petr Táborský Authors‘ workplace: Fresenius Medical Care, Praha Published in: Vnitř Lék 2020; 66(8): 28-33 Category:
Chronic kidney disease has been recognized as a worldwide epidemic. Its prevalence in developed countries is about 10 %, the number of patients treated by dialysis is on average 1.000 person per 1 million of population. Kidney failure is associated with high mortality due to high prevalence of cardiovascular disease. Cardiovascular risk factors differ in renal patients and general population. Most important of them are chronic overhydratation, anemia, disturbed calcium-phosphate metabolism, uremic toxins and protein-calorie malnutrition. Hospitalization of dialysis patient in internal medicine ward has some specific problems including dialysis tactics, care of vascular access and inpatient logistics. Dialysis tactics is expressed in dialysis prescription, where the ultrafiltration, anticoagulation and dialysate composition must be carefully planned. Peripheral veins should be saved for future vascular access, early diagnostics of thrombotic and infectious complications is necessary. Proper timing of blood sampling for laboratory investigation and drug administration must be related to dialysis schedule. Effective communication between inpatient ward and dialysis unit is essential.
dialysis – hospitalization – chronic kidney disease
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