Coda Change

Critical kidney and dialo-trauma

17 snips
Feb 13, 2024
Dr. Emily See discusses the critical implications of acute kidney injury and kidney replacement therapy. She introduces the concept of 'dialytrauma,' revealing how certain dialysis practices can harm patients. The podcast highlights the consequences of rapid fluid shifts and intradialytic hypotension, potentially worsening kidney recovery. Evidence shows significant reductions in renal perfusion and the risks of cardiac injury during dialysis. Furthermore, cognitive decline and altered organ perfusion, including the gut and liver, are explored, emphasizing the need for focused research.
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INSIGHT

Dialytrauma Is A Multiorgan Phenomenon

  • Dialytrauma describes all harmful events linked to kidney replacement therapy across organs.
  • It often stems from rapid changes in solute concentrations and volume during dialysis.
INSIGHT

Dialysis May Worsen Kidney Recovery

  • Initiating dialysis can perpetuate renal injury via intradialytic hypotension and reduced renal perfusion.
  • Animal and historical human data link transient hypotension during dialysis to worsening creatinine and tubular necrosis.
ANECDOTE

War-Era Autopsies Linked Dialysis To New Tubular Damage

  • Vietnam War patient autopsies showed fresh focal tubular necrosis after dialysis sessions weeks following the initial injury.
  • The only temporal hemodynamic events were transient blood pressure drops during repeated haemodialysis.
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