What happens if you are suddenly admitted to hospital with the symptoms of Kidney Failure?

New renal patients typically present themselves to the clinic in 2 ways:

  • The most common is as a result of impaired kidney function which is diagnosed before kidney failure. A gradual loss of kidney function may occur, during which time the patient is treated to either slow or stop this loss. If kidney failure is inevitable the patient is prepared for either dialysis or transplant through the education programme of the Advanced Kidney Care clinic.
  • The alternative route is known by staff as “crash-landing”. Here the patient is either unaware of their kidney problems until renal failure occurs or they have an unexpected sudden loss of remaining kidney function. This can be a traumatic experience, particularly in younger patients.

So what can you expect if you “crash-land”?

A patient who arrives at hospital with signs of renal failure will go through a series of intensive treatments. These might include:

  • Intravenous injections of fluids to attempt to restart the patients kidney function.
  • A biopsy to understand the nature of the damage to the kidney. In particular to determine if the loss of kidney function is as a result of acute injury (potentially reversible) or chronic kidney disease (irreversible).
  • If kidney function does not restart the doctors may decide to begin dialysis. For this a temporary access line will be inserted (possibly to the femoral vein).
  • A more long-term access method will be created a week or two later. Either a permacath access line in the neck/chest area for haemodialysis or if the patient has chosen peretoneal dialysis, then an abdominal catheter . Either way you will begin to settle into your regular dialysis routine.

Other aspects of your care will include management of your haemoglobin levels using a family of drugs called Erythropoietin (EPO). It is likely that you will require a combination of these EPO injections and venefer infusions (iron). The iron is typically given fortnightly to haemodialysis patients while dialysing.

There will be many more test and procedures that you may undergo and your renal team can advise you on what these might be.

 

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