Podcast 718: Renal Failure Follow Up

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

• Patients with acute renal failure often need medical management for hyperkalemia
• Those with severe electrolyte derangements or absent renal function may need emergent dialysis as well
• Dialysis catheters are 12 or 14 french catheters placed in the right internal jugular or left subclavian
• Placement is very similar to a central line or cordis catheter
• Trialysis catheter is one option that has an extra port that can be used for regular medication administration and drawing blood
• Do not default to use dialysis catheters for normal ED access due to risk of infection and clot development
• While dialysis catheters are typically reserved for dialysis only, they can be used in extreme circumstances, such as a cardiac arrest

References

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

Simon LV, Hashmi MF, Farrell MW. Hyperkalemia. [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/

Akaraborworn O. A review in emergency central venous catheterization. Chin J Traumatol. 2017;20(3):137-140. doi:10.1016/j.cjtee.2017.03.003

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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