A 49-year-old male with chronic renal failure will be starting hemodialysis. The nurse understands that hemodialysis is necessary for the patient because of the following:

Hyperkalemia.
Uremia.

Explanation

• The decreased excretory capability of the nephrons in chronic renal failure results in the retention of potassium. A serum potassium level of above 5.5 mEq/L may cause cardiac arrhythmias and is life-threatening. The seriousness of this situation calls for medical attention and early treatment (such as hemodialysis).

• Uremic syndrome is a serious complication of chronic kidney disease. It occurs when urea and other waste products build up because the kidneys can no longer eliminate them. It is usually diagnosed when kidney function is below 75% and creatinine clearance falls below 10-20 mL/min. Severe complications include seizure, cardiac arrest, or death. Hemodialysis is the treatment.

• Ascites is normally caused by cirrhosis, although it can be caused by chronic renal failure.

• Metabolic, not respiratory, acidosis can be treated with dialysis.

• Hypertension is related to many different factors and is not an indication for hemodialysis until antihypertensive medications have been attempted.

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