Tuesday, March 29, 2011
CONSULT ROUNDS: A primer on CVVHDF orders
How does one calculate the prescribed dose on CVVHDF?
Here is an order set:
Pre pump flow 700cc/hr
Post pump flow 400cc/hr
Ultrafiltration goal 100cc/hr
Our formula for estimated GFR is uv/p ( v=volume, u= urine crt and p= plasma crt). In this case, would be dialysate crt and plasma crt. We have to make one assumption:- since the rate is so slow, the equilibration of dialysate crt and plasma crt would cancel out and your GFR = Volume.
So then, your diffusive clearance would be your DFR, which in this case would be 1500/60 or 25cc/min
your convective clearance would be your pre +post + UF you ordered= 1200/60 or 20cc/min
Hence, you are getting this person 45cc/min of prescribed GFR. Doesn't mean that is the DELIVERED dose.
One more aspect that might be missing is the residual urine output which might be good and might only add to the GFR.
Just an interesting exercise that we should do all time we do CVVHDF orders.
Also, this helps pharmacy guide your medication prescriptions
- ► 2017 (42)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Nephronpower Views
- HyperKalemia Challenge
- TOPIC DISCUSSION: Residual renal function???
- AST Fellows Symposium on Transplantation Medicine
- CONSULT ROUNDS: Ranolazine and the Kidney?
- CONSULT ROUNDS: A primer on CVVHDF orders
- CLINICAL CASE 33, ANSWERS and SUMMARY
- Who gets kidney first?- the thoughts in 2011
- IN THE NEWS- E Nephrology
- Concept Map of Viruses and the diseases in the kid...
- TOPIC DISCUSSION: What causes Foamy Urine?
- ATC and NKF Abstracts 2011 are on line for viewing...
- Kidney transplant and donation cancer risks
- Concept Map of HIV, Hep C and Hep B and the Kidney...
- Viruses and the Kidney, a primer! ( a case based a...
- Concept Map of Viruses and the Kidney, a general m...
- CONSULT ROUNDS: Preparing For a Pheochromocytoma R...
- Kidney Transplant Recipient Infected With HIV From...
- TOPIC DISCUSSION: Contraction Alkalosis or CDMA?
- TOPIC DISCUSSION: Lactate levels and B2 agonists? ...
- CONSULT ROUNDS: Cefepime Neuro-toxicity and the Ne...
- More Pediatric Grand Rounds from www.pediatric-nep...
- Olmesartan for Patients with Diabetes
- ASN Review course 2011
- Hematuria Post Kidney Transplantation
- Notes from Dr. RW: Hyponatremia update
- Paraproteins and the Kidney
- Concept Map of Hypernatremia
- TOPIC DISCUSSION: TB and the Kidney
- Virtual Library ( the Welch Library) Part 2
- IN THE NEWS: Belimumab and Lupus
- Top Ten Reasons to Love you Kidneys
- Virtual Library ( the Welch Library) Part 1
- Elimination of anti rejection medicaitons
- Smoldering vs Active Myeloma
- Tissue Engineering Renal Tissue
- Concept Map of Hyponatremia
- Concept Map of BK Nephritis Treatment
- Bortezomib for desensitization!
- JOURNAL CLUB: FHN Trial
- Complications of Peritoneal Dialysis
- TOPIC DISCUSSION: Amyloidosis and Factor X deficie...
- CLINICAL CASE 34, ANSWER AND SUMMARY
- IN THE NEWS--> DOSE TRIAL
- ANCA VASCULITIS
- CONSULT ROUNDS: An approach to orthostatic hypoten...
- In the News: Transplant rules changing
- Concept Map of Kidney Injury in hematopoietic Stem...
- Growing Kidneys
- ▼ March (49)
- ► 2010 (461)