Hi, it’s Patrik Hutzel from www.intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “your questions answered” and in this week’s episode I want to answer and I want to explain to you
“Why your critically ill loved one might need Dialysis(Kidney machine) or Haemofiltration for Kidney Failure(Renal Failure) and is having a Dialysis machine attached to them!”(PART 1)
With all the challenges that you are already dealing with whilst your loved one is critically ill in Intensive Care, you might have now been told or you might have seen that your critically ill loved one has been attached to a Dialysis machine or Kidney machine.
This generally means that your critically ill loved one has gone into kidney failure and it means that your loved one’s kidneys have stopped working properly!
Therefore, your critically ill loved one requires a form of kidney replacement therapy so that the function of the kidneys can be replaced. This is what the Dialysis or kidney machine is doing in essence, it’s replacing the function of the kidneys.
Your next question probably is, what has led to the kidneys working properly?
There are a number of factors that lead to acute kidney failure(renal failure). Some of those reasons are caused by the therapy in Intensive Care and some of them are caused by the disease process of your loved one!
The most common reasons for kidney failure in Intensive Care are
• Low blood volume and therefore insufficient blood supply to the kidneys due to blood loss/ bleeding, mainly after surgery or after traumatic accidents
• Abnormal or insufficient blood flow to and from the kidneys due to obstruction of the renal artery or vein
• Dehydration from loss of body fluids due to insufficient fluid intake or loss of such through vomiting, diarrhoea, sweating or fever
• Sepsis, which is the overwhelm of the body’s immune system from an infection and therefore causes inflammation and “shutdown” of the kidneys
• Rhabdomyolysis: In Rhabdomyolysis there is significant muscle breakdown in the body, and the damaged muscle fibres clog or obstruct the filtering system of the kidneys. This is usually a result of severe trauma, crush injuries, and burns
• Heart failure after CABG, heart attack, cardiac arrest, Cardiomyopathy due to insufficient blood supply/ blood perfusion to the kidneys
• Poorly controlled Diabetes, high blood sugar and poorly controlled high blood pressure can cause kidney failure as well
These are the most common reasons for going into kidney failure in Intensive Care. The list is not exhaustive, however the list presents the most common reasons for kidney failure in Intensive Care.
There are other reasons why Patients in Intensive Care go into kidney failure and require the Dialysis machine, however the reasons below are no major reasons for kidney failure in Intensive Care
• Acute glomerulonephritis or inflammation of the glomeruli, the filtering system of the kidneys
• Obstruction of the bladder or the ureters can cause back pressure because the kidneys continue to produce urine, but the obstruction acts like a dam, and urine backs up into the kidneys. When the pressure increases high enough, the kidneys are damaged and shut down
The signs& symptoms of your critically ill loved one having gone into renal failure are as follows
• Low Urine output
• Oedema(swelling of feet, ankles and the pelvic region)
• High Potassium levels in the blood and the kidneys inability to clear out Potassium
• Increased Urea and Creatinine (specific kidney markers in blood results)
• If the Urea level is climbing too high, signs of confusion and drowsiness may be present
After your critically ill loved one has been diagnosed with acute Kidney failure, the next step is to try a diuretic drug(drug that promotes the production of Urine), such as Frusemide or Lasix to increase Urine output. If the Frusemide or Lasix doesn’t work than your loved one is likely to have the Dialysis machine attached to them in order to completely replace the function of the kidneys.
Once the decision has been made to commence “Renal replacement therapy” or the Dialysis machine, the next steps are to insert a Dialysis Catheter into your loved one’s groin, shoulder or neck into one of the large veins. Once the Dialysis Catheter has been inserted the Dialysis therapy can be commenced.
Initially, it is the main goal to remove excess fluids from your loved one’s body and reduce the oedema and also to get Potassium, Urea and Creatinine levels back to normal.
This can take quite a while and it can take up to a few days and depending on the causes of the kidney failure can sometimes take weeks.
With Urea and Creatinine(the specific kidney markers in the blood) coming down and coming back to normal, the kidneys should start to slowly but surely work again and produce Urine.
The next steps then are to take your loved one off the kidney machine and see whether he or she starts to produce Urine. If that’s the case then the “Renal replacement therapy” has been effective and achieved its goal.
In other cases, the kidney machine may have been taken off and your critically ill loved one doesn’t show any signs of producing Urine and therefore the Dialysis machine needs to go back and more Fluids need to be removed until the kidneys start working again!
In next week’s episode I want to continue this series by explaining “how long your critically ill loved one can stay on a Dialysis machine and also what’s happening if your loved one needs Dialysis outside of Intensive Care”.
If you want to have control, power and influence whilst your loved one is critically ill in Intensive Care and if you want to be perceived as strong, influential, impactful and knowledgeable by the Intensive Care team and if you want to be in control of your and your critically ill loved one’s destiny and if you want to make an impact, download your FREE “INSTANT IMPACT” REPORT NOW by entering your email below!
In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!
- How to ask the doctors and the nurses the right questions
- Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
- How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
- 5 “killer” tips& strategies helping you to get on the right path to PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
- How to stop being intimidated by the Intensive Care team and how you will be seen as equals
- You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
- How you need to manage doctors and nurses in Intensive Care(it’s not what you think)
Thank you for tuning into this week’s blog and I’ll see you again in another update next week!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!