Podcast 1022: Emergent Dialysis

Contributor: Taylor Lynch, MD

Educational Pearls:

When a patient who missed dialysis presents to the emergency department, our clinical concern is who needs to be admitted to the hospital for emergent dialysis and who can wait for their next regularly scheduled session.

Dialysis sessions typically occur on Monday, Wednesday, and Friday, or Tuesday, Thursday, and Saturday.

Acronym for indications for emergent dialysis: AEIOU

Acidosis

Patients may have an underlying cause for acidosis such as sepsis or DKA.

Treat the underlying cause, but if the acidosis is unable to be corrected, the patient needs dialysis.

Electrolytes

Most commonly elevated is potassium.

In general, dialysis patients tend to have higher potassium levels, so don't just treat the number.

Look for potassium greater than 6.5 or if EKG changes are present.