Clinical meaning
Hemodialysis and Renal Replacement Therapy involves disruption of renal filtration, tubular function, electrolyte homeostasis, or acid-base balance specific to hemodialysis and renal replacement therapy.
Diagnosis & workup
Diagnostics & workup: - CBC for anemia of CKD evaluation - Urinalysis with microscopy (casts, crystals, cells) - Renal ultrasound for size, echogenicity, obstruction, masses - BUN/Creatinine ratio (>20:1 suggests prerenal etiology) - Urine albumin-to-creatinine ratio (UACR >30 mg/g = albuminuria) - Renal biopsy for unexplained proteinuria, hematuria, or AKI - PTH and vitamin D levels for renal osteodystrophy assessment
Risk factors: - Nephrotoxic medications (aminoglycosides, vancomycin, amphotericin B) - Age >60 with age-related GFR decline - Family history of polycystic kidney disease or Alport syndrome - Hypertension (second leading cause of CKD) - NSAID use >7 days (prostaglandin-mediated afferent arteriolar constriction) - Rhabdomyolysis from trauma, statins, or extreme exertion - Multiple myeloma with cast nephropathy