PRE-DIALYSIS MANAGEMENT OF CRF


Abbreviated medical protocols from EdREN, the website of the Renal Unit of the Royal Infirmary of Edinburgh


The aim is to:

 

Fluid balance Prevent hypervolaemia (Na restriction, diuretics)
Avoid hypovolaemia (no oedema, postural hypotension)
Watch out for sodium-losing patients who will benefit from Na supplementation.
Hypertension See blood pressure in renal disease
Diet See diet
Hyperlipidaemia See hyperlipidaemia
Acidosis Prescribe NaHCO3 to keep plasma bicarbonate 20 if Na load permits
Osteodystrophy

Prescribe alfacalcidol (calcitriol equally effective) when there is hypocalcaemia or when PTH >2x normal in the presence of normal serum calcium.
PO4 should be kept at
1.8 mmol/l by dietary restriction and the use of phosphate binders.

See osteodystrophy.

 

 

Neil Turner was the main author for this page, last amended Thursday, November 30, 2006.

NOTE that the accuracy of any statements in this information CANNOT be guaranteed. It is published in the belief that it is correct, and we endeavour to keep it so - but we do make mistakes. Furthermore, over some subjects there are differing opinions, or differing degrees of certainty. We have usually not attempted to discuss these here because the aim has been to provide an immediate and brief guide. In all areas, prior medical knowledge is assumed. The EdRenHANDBOOK is not suitable for use by those without such a background. Contact us by email or at the address given at the foot of the contents page with any comments or corrections.

 

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