Podcast 718: Renal Failure Follow Up

<p><strong>Contributor: Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Patients with acute renal failure often need medical management for hyperkalemia</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Those with severe electrolyte derangements or absent renal function may need emergent dialysis as well</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Dialysis catheters are 12 or 14 french catheters placed in the right internal jugular or left subclavian</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Placement is very similar to a central line or cordis catheter</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Trialysis catheter is one option that has an extra port that can be used for regular medication administration and drawing blood</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Do not default to use dialysis catheters for normal ED access due to risk of infection and clot development</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">While dialysis catheters are typically reserved for dialysis only, they can be used in extreme circumstances, such as a cardiac arrest</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Co I, Gunnerson K. Emergency Department Management of Acute Kidney Injury, Electrolyte Abnormalities, and Renal Replacement Therapy in the Critically Ill. Emerg Med Clin North Am. 2019;37(3):459-471. doi:10.1016/j.emc.2019.04.006</span></p> <p><span style="font-weight: 400;">Simon LV, Hashmi MF, Farrell MW. Hyperkalemia. [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:</span> <a href= "https://www.ncbi.nlm.nih.gov/books/NBK470284/"><span