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Indications for hemodialysis

Acute kidney injury

Intoxication

Overhydration (ultrafiltration)

Acute kidney injury (AKI): indications for hemodialysis

01

Oliguria/anuria

02

Uncontrolled clinical signs

03

Severe hyperkalemia

04

Severe fluid overload

05

Progressive azotemia

06

Severe acid-base disturbance

Prognosis of AKI

Toxic injury

Variable prognosis

Infectious causes

Favorable

Ischemia

Favorable

Survival of AKI

The survival associated with AKI is extremely variable.

Factors associated with a lower likelihood of survival includes

  1. Lower body weight

  2. Anemia

  3. Low lymphocyte count

  4. Higher creatinine

  5. Higher phosphorus level

  6. Lower ionized calcium

  7. Higher anion gap

  8. Increased ALT

  9. Lower urine production

  10. Increased respiratory rate

  11. Presence of neurologic signs

  12. Presence of DIC

  13. Ethylene glycol toxicity

Dogs with Dog Walker

54%

Four Cats on the Sidewalk

48%

   Important facts

  • Hemodialysis is non-invasive and non-painful

  • Clinical signs improve significantly during hemodialysis

  • Goal of hemodialysis is to provide kidney support while waiting for kidneys to recover

  • Best patient care

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