PENGENALAN KEPADAHEMODIALISIS

Disediakan Oleh : Nassruto

FUNGSI BUAH PINGGANG NORMAL

Functions of the kidney

• To maintain the balance of water by removing excess fluid from the body.

•  Healthy kidneys filter the blood to remove waste products such as urea and creatinine.

• To maintain normal body chemistry. A number of solutes such as potassium, sodium, phosphorus, calcium, bicarbonate, magnesium and chloride are important to blood chemistry.

• The kidneys also produce three important hormones:

• Erythropoietin: which is produced to control the production of red blood cells, in the bone marrow, to prevent anaemia. • Active vitamin D:  which helps the body absorb

calcium from food. Bones need calcium to stay strong and healthy. • Renin: which helps regulate blood pressure.

APA AKAN BERLAKU APABILA BUAH PINGGANG BERHENTI BERFUNGSI ?

Renal Failure

• Acute•Suddent onset.•Urine Output •Reversible.

• Chronic•Slow progress.•Menyebabkan kegagalan sepenuhnya.

Penyebab Acute Renal Failure

• Prerenal•Kekurangan isipadu darah.•Kekurangan bekalan darah.•Kegagalan fungsi jantung.

Samb.

• Intra Renal•Vascular-Acutetubular necrosis •Glumerulus- Lupus nephritis•Kecederaan pada tubul.

• Post Renal-Obstruction•Ureter•Bladder

Cont.

• Ischemic.• Hypotension shock• Sepsis

• Nephrotoxin• Antibiotic• Radiocontras• Heavy metal

• Heme protein• Myoglobin

Causes of Chronic Renal Failure

• Diabetes • High blood pressure • Glomerulonephritis • Polycystic kidney disease • Scarring from kidney infection in

childhood • Obstruction

SIGNS AND SYMPTOMS

• Generally feeling ill. Tiredness and loss of energy• Lacking interest in everyday activities,

difficulty in concentrating or relaxing. • Shortness of breath.• Altered taste sensation/appetite.

Cont.

• Sickness and nausea • Loss of libido / sex drive • Itch • Swelling of the legs

cont.

• Oliguria• Anuria• Odema• Eletrolite Imbalances.• Fluid overload.

E.S.R.D

Investigation

• Blood test.• Imaging test.• Kidney biopsy.• Urine analysis.

INDIKASI DIALISIS

• Uraemic syndrome• Hyperkalemia• Acidosis• Fluid overload

SIAPA PERLU DIALISIS ?

• Acute dialisis.Pesakit ARF, CRF.

• Chronic dialisis.ESRF, Failed transplant, Failed

CAPD.

PILIHAN BAGI R.R.T. ?

• HEMODIALISIS• C.A.P.D• RENAL

TRANSPLANTION

APA ITU HEMODIALISIS ?

HEMODIALISIS

• Haemo - Darah.• Dialysis - Proses di mana kandungan

bahan larut dalam darah ditapis dengan cara ‘mendedahkannya’ kepada dialysate melalui semipermeable membrane.

PROSES HEMODIALISIS

KEPERLUAN BAGI HEMODIALISIS

• WATER TREATMENT SYSTEM• MESIN HEMODIALISIS • DIALYSATE• PATIENT• DIALYZER AND BLOODLINES.

WATER TREATMENT SYSTEM

• R/O. REVERSED OSMOSIS WATER.• Water is one of the most essential components of the

dialysis fluid. Therefore, high quality water, both from a chemical and microbiological point of view, is essential for a good long term outcome.

BAGAIMANA H.D BERFUNGSI ?• Darah dikeluarkan melalui fistula dengan menggunakan AVF needles.• Disalurkan ke Dialyzer melalui Bloodlines

dengan bantuan Mesin Hemodialisis.• Catheter khas digunakan jika ketiadaan

fistula.

Diagram HD

A.V. Fistula Needling

I.J. CatheterI.J. Catheter

REHAT 4 JAM

Dialyzer• Terdapat 2 ruang.

• Ruang Darah.• Ruang Dialysate.

• Dipisahkan oleh fiber dialyzer.

• Kotoran dan air akan keluar dari darah ke dialysate melalui ‘diffusion’, dan ‘ultrafiltration’.

Samb.

• Proses ini berlaku berterusan selama 4 jam.• Kepekatan kotoran , air, garam-garam

buangan akan berkurangan ke paras yang kurang bahaya.

PENJAGAAN PESAKIT H.D

• PENJAGAAN KEBERSIHAN DIRI

• Sekian Terima Kasih