- Renal diet (Na < 4 gm, protein 1 gm/kg)
- Fluids: D5 1/4 NS for total fluid < 1 liter qd (for insensible losses);
- Daily Wts;
- Useful Medications:
-
1,25 OH Vit D, MVI, Ca acetate (if appropriate)
-
Erythropoietin 25-500 U per Kg wt;
-
Zantac 150 mg PO qhs;
- MVI qd (loss of water soluble vits with
dialysis)
-
DDAVP w/ bleeding
-
Calcium Supplements:
- Ca Acetate 669 mg PO qAC, or CaCO3 0.5 to 1.5 gm tid w/ meals;
- binds more Phosphorous than Ca Carbonate;
- Ca Carbonate: may need upto 8-12 gm/day;
- PhosLo 1 tab qAC,
- Harmful Meds:
- KCL, Mg, PO4;
- sulfonamides (w/ anemia)
- amphogel & basaljel as these are associated with osteodystrophy;
-
demerol
- Decrease Dosage:
-
Digoxin
-
Gentamicin
-
Betalactams
-
Phenothiazines
-
Insulin (decr renal catabolism)
-
Atenolol
-
Procainamide
- H2 Blockers
- Limit milk intake;
- Labs:
- Chem 7, Ca, Mg, Phos qd, Alk Phos qod;
- Dextrose Stick qAc and qHs
- CBC q weekly (Hct > 25 w/ bleeding);
- Urine Analysis qod /UCx
- Urine Lites q24
- 2 hr CrClr q12
- Urine-Myo-Heme q12
