The first 90 days
- In research, patients in their first 90 days of dialysis were twice as likely to die as those who had been doing treatments longer.
- Patients who start dialysis with a fistula or graft are more likely to live than those who have an HD catheter.
- Fluid Removal: if the patient is still making urine, you may not need to remove a lot of fluid. You want to avoid making the patient’s BP drop to prevent organ stunning.
- Less heparin because CKD slows clotting
- Higher K bath because removing too potassium too quickly can cause abnormal heart rhythms.
- Shorter treatments. Start with 2 hours and add 15 to 30 minutes with each treatment.
- Gentle treatments may needed for a few days in a row.