Complications
Caused partly by renal failure but mainly by comorbidities.
Transfusion agents may be required.
Results in ECG abnormalities (i.e., peaked T waves, increased PR interval, widened QRS, atrial arrest, and deterioration to a sine wave pattern) and cardiac arrhythmias.
Hyperkalemia may be treated by restriction of dietary intake, potassium binding ion exchange resins, and loop diuretics.
Emergency measures for this include intravenous insulin and glucose, and hemodialysis.
If hyperkalemia is refractory to medical treatment or if cardiac manifestations are present, hemodialysis is indicated for rapid potassium normalization.
Caused by renal impairment.
Oral bicarbonate preparations such as sodium citrate/citric acid may be used to manage metabolic acidosis.
Management often requires dialysis if severe and if respiratory compensation is unable to maintain pH.
Severe kidney injury, especially in patients with underlying kidney disease or other comorbid medical conditions; may not recover and renal replacement therapy may be required.
Caused by dysfunction of platelets due to uremia.
Requires treatment with desmopressin, estrogens, correction of anemia, and dialysis.
Uremic toxins accumulate with severe and untreated renal failure resulting in lethargy and confusion. Pericarditis may develop.
Dialysis is required for management of uremia.
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