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CE ARTICLE Table 4: Normal Ranges for Lab Values Commonly Efected by CRF Placing a patient on dialysis fundamentally changes their life and marks a transition in Lab Normal Range Efect in CRF their health from a regular and BUN ......................... 8–25mg/dl ....................elevated constant body cleansing of toxins Creatinine ............... 0.6–1.2 mg/dl ................elevated Potassium ............... 3.5–5 mEq/L .................elevated to a lifestyle where there is recurSodium ................... 135–145 .........................decreased rent buildup followed by rapid Bicarbonate ............ 22–26 ............................decreased removal. The result is significant pH ............................ 7.35–7.45........................decreased effects on nearly every organ system of the body. All other patients with ESRD will receive The cardiovascular system is affected dialysis treatment several (typically three) in several ways. Chronic anemia develops times a week. Dialysis is an intervention and results in chronic fatigue, reduced that does nothing to treat the cause of physical capacity to perform daily ESRD; rather, it temporarily corrects the functions, impaired immune function effects of poorly functioning kidneys. and cognition, reduced quality of life, Dialysis removes excess fluids and elecincreased cardiovascular disease and trolytes, toxins (urea) and other wastes no increased mortality.7 A normal hemolonger eliminated effectively.There are two globin is roughly 15 g/dL; in 2010, 10% forms of dialysis: peritoneal dialysis and of ESRD patients experienced a hemohemodialysis.The vast majority of patients globin of less than 10 g/dL, and only receive hemodialysis either in a hospital 21.7% had hemoglobin greater than or at one of the thousands of outpatient 12 g/dL.1 Platelets are also stressed and dialysis centers across the country. prone to damage during hemodialysis. Overall heart disease is the leading cause of death for ESRD patients; heart failure, left ventricular hypertrophy, arteriosclerosis and stroke are all common. Hypertension, if not already a contributing cause of the renal failure, becomes a significant problem for patients as their ability to regulate the RAAS progresses. This is further exacerbated by the body's inability to excrete sodium and fluid effectively. In addition to sodium balance concerns, patients with ESRD also need careful potassium balance; hyperkalemia is a common problem. The risk for experiencing hyperkalemia is exacerbated by the body's increased catabolism (cell destruction), chronic acidosis from waste accumulation, and potassium-based medicines. The normal potassium range is 3.5–5 mEq/L, and levels become dangerous above 6 mEq/L. Advanced providers may see the earliest signs of hyperkalemia on an EKG by the presence of peaked 600 Series Easy-Fold Stretchers JSA-604-S All Junkin Easy-Fold Stretchers come with 2" wide standard, automotive-style patient restraint straps and 18 oz. fungus and rot resistant vinyl covers for long-lasting durability and easy clean-up. Each fold to a compact size for easy storage. JSA-602 JSA-603 PROUDLY MANUFACTURED IN THE USA 888-458-6546 3121 Millers Lane Louisville, KY 40216 Tel: 502-775-8303 Fax: 502-772-0548 For More Information Circle 39 on Reader Service Card 54 MARCH 2013 | EMSWORLD.com S A F E T Y A P P L I A N C E CO M PA N Y www.junkinsafety.com For More Information Circle 40 on Reader Service Card