RESIDENT-CONSULTANT INTERACTION TOOL

Name of Resident: Francis Jestin S. Aquino, MD Year Level: II

DATE CASE NUMBER PATIENT’S AGE PATIENT’S SEX
01/04/2023 45 Female

CASE

What is the absolute indication of dialysis

INPUT OF THE RESIDENT

The absolute indications for dialysis are conditions in which the initiation of dialysis is considered
necessary to sustain life or prevent significant morbidity. These indications include:

Severe Uremia: Uremia refers to the accumulation of waste products and toxins in the blood due to
kidney failure. If a patient experiences severe uremia with symptoms such as persistent nausea and
vomiting, mental confusion, pericarditis (inflammation of the lining around the heart), uncontrollable
bleeding, or impaired consciousness, dialysis may be required to remove these waste products and
restore electrolyte and acid-base balance.

Refractory Fluid Overload: In cases where there is severe fluid overload that cannot be managed
effectively with diuretic medications or leads to significant symptoms such as pulmonary edema
(fluid in the lungs) or compromised cardiac function, dialysis may be necessary to remove excess
fluid from the body.

Severe Electrolyte Imbalance: Certain electrolyte imbalances that cannot be corrected by other
means can be an indication for dialysis. Examples include severe hyperkalemia (elevated potassium
levels) refractory to medical therapy, severe metabolic acidosis with a pH less than 7.1, or severe
hyponatremia (low sodium levels) with neurological symptoms.

Intoxications or Overdoses: In cases of severe drug overdoses or poisoning where dialysis can
effectively remove toxins from the blood, it may be indicated. This includes certain medications, such
as lithium or methanol, or substances with a high dialyzability, like ethylene glycol.

Acute Kidney Injury (AKI): In some cases of acute kidney injury, dialysis may be necessary to support
kidney function while the underlying cause of the injury is being treated or resolved. This includes
situations where AKI leads to severe electrolyte imbalances, fluid overload, or uncontrolled uremia.

FEEDBACK OF THE CONSULTANT

Dr. Cruz
Consultant-Evaluator
Name and Signature