E-Mail: hemodialysisarunhospital@ymail.

com

TRAVELLING DIALYSIS
Patient’s Name : Asfiat
Age : 40 Years
Sex : Farmale
Recent address : Desa Tingkeum Manyang, Kec. Kuta Blang Bireun
Diagnosis : CKD St V Dialisis ec HN
Home dialyzed or center dialyzed : Center Dialyzed
Date of first dialysis : 3-Apr-13
Recent Blood Pressure Status
Pre – Dialysis : 130/90 mmHg
Post – Dialysis : 150/90 mmHg
Vascular Access : CAPD ( Cimino )
Type of dialyzer : F7 HPS
Blood flow rate (QB) : 300 ml/minute
Type Dialysate : Bicarbonate
Dialysate Flow rate (QD : 500 ml/minute
Anticoagulant : Inviclot, Lovenox
Loading dose : 1000 ui
Maintenance dose : 4000 ui
Patient’s Dry Weight : 54 kg
UF Goal : 3000 ml
UF Rate : 600 ml/hour
Numbers of runs per week : 2 / weeks
Lenght of dialysis : 5 hour
Complication during dialysis : -
Allergic : -
Serologic Test : HBsAg Negatve 3-Apr-13
Ant HCV Positve 3-Apr-13
Ant HIV Negatve 3-Apr-13
Current Medications : Amlodipine 5 mg Hemapo 3000 iu
Valsartan 80 mg Lenal Ace
Relevant Clinical History :

7-Mar-16
Sincerely yours,
dr.Rahmawati A.Latief, Sp.PD.KGH - FINASIM