A 26 year old with diabetes mellitus has developed renal failure. While waiting

Question

A 26 year old with diabetes mellitus has developed renal failure. While waiting for a kidney transplant, he is on maintenance hemodialysis eight to ten hours three times each week. He is on a diet restricted in sodium (500 mg/day), potassium (2.6g/day), and protein as well as his usual diabetic diet. He has a shunt in his right wrist to allow for easy hookup to the dialysis machine. Prior to hemodialysis, his representative blood values are as:

Serum sodium - 120 mEq/L

Serum potassium - 6.4 mEq/L

Serum chloride 102 mEq/L

Hematocrit - 24%

The dialysis fluid in the kidney dialysis machine contains the following:

Sodium -134 mEq/L

Potassium - 2.6 mEq/L

Calcium - 2.5 mEq/L

Magnesium - 1.5 mEq/L

Chloride - 104 mEq/L

Sodium Acetate - 36.6 mEq/L

Anhydrous dextrose - 2 g/L

1. Following eight to ten hours of hemodialysis, do you think the following blood values would be increased, decrease, or remain the same?

Plasma sodium

Plasma potassium

Plasma chloride

Plasma creatine

Hematocrit

As well why does anemia usually develop with renal disease?

Explanation / Answer

Following eight to ten hours of hemodialysis, The plasma sodium, potassium, chloride concentration is decreased and as the small molecules like ions are removed and reabsorption capacity of kidneys is totally decreased.

The plasma creatine concentration remains same because it is not totally removed through dialysis and its concnetration in blood is the indication of kidney failure.

The hematocrit increased after dialysis.

Anemia is usually developed with renal disease. This is because kidneys secrete a hormone called hematopoietin that is required for the RBC production. The decrease in the function of kidneys decreases the hormone secretion and inturn decreases the RBC production and hence people suffering with renal disease develop anemia.

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