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Discussion

Dialysis?

I wanted to ask, a patient of mines received 2 packs of rbc's stat yesterday while undergoing dialysis. My question is did he get the blood because of volume depletion or possible he was going into hypovolemic shock.

I was wondering if someone could explain the process.:D thank you....

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  • Columnist

Anemia is common in people with kidney disease. Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to produce the proper number of red blood cells needed to carry oxygen to vital organs. Diseased kidneys, however, often don't make enough EPO. As a result, the bone marrow makes fewer red blood cells. Other common causes of anemia include loss of blood from hemodialysis and low levels of iron and folic acid. These nutrients from food help young red blood cells make hemoglobin (Hgb), their main oxygen-carrying protein.

Anemia may begin to develop in the early stages of kidney disease, when there is still 20 percent to 50 percent of the normal kidney function. Anemia tends to worsen as kidney disease progresses.

Hope this helps.

  • Columnist

Your patient is probably receiving some type of EPO injections (Procrit, Aranesp, etc.) during dialysis as well.

  • Author

Thank you. Originally my patient was taking Procrit. When I checked his upadted MAR. it didn't have it listed.

\Thank you sooooooo much for the info!!!!!!:yeah::bow:

  • Columnist

Your patient may be receiving Epogen (Procrit) and/or iron intravenously during dialysis. His Hgb, Hct, ferritin level, and TSAT (transferrin saturation) will be closely monitored and will determine what he will receive during dialysis.

When renal failure pts need a transfusion due to anemia, most docs want it given during dialysis, so that fluids received with the transfusion can be removed during dialysis, in order to prevent the pt from going into CHF, or becoming fluid overloaded.

Most of these pts get Procrit or Epogen with every dialysis tx.

On the other hand,

Dialysis pts can have a high hematocrit and be hypovolemic at the same time, as plasma fluids are removed with dialysis, but RBCs are not. RBCs can be highly concentrated in a hypovolemic dialysis pt, leading to high H&H.

  • Author

Thank you to each of you for explaining!!!!!!! I do appreciate it!!!!!!:D

:yeah::yeah::yeah::yeah::yeah:

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