renal failure & dialisis

31
PENGENALAN KEPADA HEMODIALISIS Disediakan Oleh : Nassruto

Upload: muhammad-nasrullah

Post on 08-Feb-2017

134 views

Category:

Health & Medicine


4 download

TRANSCRIPT

Page 1: Renal Failure & Dialisis

PENGENALAN KEPADAHEMODIALISIS

Disediakan Oleh : Nassruto

Page 2: Renal Failure & Dialisis

FUNGSI BUAH PINGGANG NORMAL

Page 3: Renal Failure & Dialisis

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.

Page 4: Renal Failure & Dialisis

• 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.

Page 5: Renal Failure & Dialisis

APA AKAN BERLAKU APABILA BUAH PINGGANG BERHENTI BERFUNGSI ?

Page 6: Renal Failure & Dialisis

Renal Failure

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

• Chronic•Slow progress.•Menyebabkan kegagalan sepenuhnya.

Page 7: Renal Failure & Dialisis

Penyebab Acute Renal Failure

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

Page 8: Renal Failure & Dialisis

Samb.

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

• Post Renal-Obstruction•Ureter•Bladder

Page 9: Renal Failure & Dialisis

Cont.

• Ischemic.• Hypotension shock• Sepsis

• Nephrotoxin• Antibiotic• Radiocontras• Heavy metal

• Heme protein• Myoglobin

Page 10: Renal Failure & Dialisis

Causes of Chronic Renal Failure

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

childhood • Obstruction

Page 11: Renal Failure & Dialisis

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.

Page 12: Renal Failure & Dialisis

Cont.

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

Page 13: Renal Failure & Dialisis

cont.

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

Page 14: Renal Failure & Dialisis

E.S.R.D

Page 15: Renal Failure & Dialisis

Investigation

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

Page 16: Renal Failure & Dialisis

INDIKASI DIALISIS

• Uraemic syndrome• Hyperkalemia• Acidosis• Fluid overload

Page 17: Renal Failure & Dialisis

SIAPA PERLU DIALISIS ?

• Acute dialisis.Pesakit ARF, CRF.

• Chronic dialisis.ESRF, Failed transplant, Failed

CAPD.

Page 18: Renal Failure & Dialisis

PILIHAN BAGI R.R.T. ?

• HEMODIALISIS• C.A.P.D• RENAL

TRANSPLANTION

Page 19: Renal Failure & Dialisis

APA ITU HEMODIALISIS ?

Page 20: Renal Failure & Dialisis

HEMODIALISIS

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

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

Page 21: Renal Failure & Dialisis

PROSES HEMODIALISIS

Page 22: Renal Failure & Dialisis

KEPERLUAN BAGI HEMODIALISIS

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

Page 23: Renal Failure & Dialisis

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.

Page 24: Renal Failure & Dialisis

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.

Page 25: Renal Failure & Dialisis

Diagram HD

Page 26: Renal Failure & Dialisis

A.V. Fistula Needling

I.J. CatheterI.J. Catheter

Page 27: Renal Failure & Dialisis

REHAT 4 JAM

Page 28: Renal Failure & Dialisis

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’.

Page 29: Renal Failure & Dialisis

Samb.

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

buangan akan berkurangan ke paras yang kurang bahaya.

Page 30: Renal Failure & Dialisis

PENJAGAAN PESAKIT H.D

• PENJAGAAN KEBERSIHAN DIRI

Page 31: Renal Failure & Dialisis

• Sekian Terima Kasih