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BIOLOGY chapter 15 > 15.8 Kidney failure > Flashcards

15.8 Kidney failure Flashcards

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1
Q

what are the reasons for kidney failure (3)

A
  • kidney infection (podocyte/tubule structure damaged)
  • raised blood pressure (damage epithelial cells and basement membrane)
  • genetic conditions
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2
Q

what does polycystic kidney disease do

A
  • genetic

- healthy kidney tissue is replied by fluid-filled cysts or damaged by pressure from cysts

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3
Q

what effect does high blood pressure have on the kidney

A
  • protein in urine (basement membrane/podocytes are damaged so can’t filter correctly)
  • blood in the urine (filtered incorrectly)
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4
Q

what are the effects of urea and mineral ion conc building up due to kidney failure (6)

A
  • loss of electrolyte balance
  • build-up of toxic urea in blood
  • high blood pressure
  • weakened bones
  • pain + stiffness in joints
  • anaemia
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5
Q

how does a loss of electrolyte balance happen

A
  • body cannot excrete excess sodium, potassium and chloride ions
  • causes osmotic imbalances in tissues
  • eventual death
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6
Q

why do bones get weaker if they kidneys fail

A

calcium/ phosphorus balance is lost in the blood

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7
Q

what causes anaemia

A
  • kidneys produce hormone called erythropoietin which stimulates production of RBCs
  • kidney failure = less production of RBCs
  • causes tiredness and lethargy
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8
Q

how is GFR used to indicate kidney disease

A
  • blood test measures creatinine
  • is a breakdown product of muscles and gives estimated GFR
  • high levels indicate kidneys aren’t working properly
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9
Q

what are the units for eGFR

A

cm3/min

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10
Q

what factors need to be considered when calculating GFR

A
  • decreases steadily with age even if healthy

- men have more muscles mass so more creatinine

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11
Q

what do GFR levels of 60 and 15 indicate

A
  • below 60 for 3 months = chronic kidney disease

- below 15 = kidney failure

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12
Q

what is haemodialysis

A

blood is removed and passed through a machine containing an artificial dialysis membrane which allows counter-current exchange

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13
Q

explain the process of haemodialysis

A
  1. blood leaves from artery into dialysis machine
  2. flows between a partially permeable dialysis membrane (mimics basement membrane)
  3. patients lose excess urea and some mineral ions
  4. dialysis fluid has normal plasma levels of mineral ions so if there is a shortage they move down a conc gradient into the blood
  5. no urea in dialysis fluid so it goes out of the blood due to steep conc gradient
  6. countercurrent system as blood and fluid flow in opposite directions
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14
Q

how long does haemodialysis take

A
  • 8 hours

- repeated several times a week

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15
Q

how is the diet controlled for haemodialysis

A
  • diet and fluids are monitored

- can only eat/drink at the start of the process to avoid forming excess urea

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16
Q

what is peritoneal dialysis

A
  • makes use of the natural dialysis membranes formed by the abdomen lining (peritoneum)
  • done inside the body
  • done at home and patient carries on with normal life
17
Q

explain the process of peritoneal dialysis

A
  1. dialysis fluid introduced to the abdomen by a catheter
  2. left for several hours as dialysis takes place across the peritoneal membranes
  3. urea and excess mineral ions pass out of capillaries–> tissue fluid–> across peritoneal membrane–> dialysis fluid
  4. fluid is drained off and discarded
18
Q

what happens in a kidney transplant

A
  • new kidney is implanted into a patient’s body to replaced a damaged kidney
  • blood vessels are joined
  • ureter is inserted into the bladder
19
Q

where can the kidney in a kidney transplant come from

A
  • people with the same blood/tissue type (often living relative)
  • people who have just died and donated their organs
20
Q

what are possible problems of a kidney transplant

A
  • operation can be risky
  • immune system may reject the transplant as antigens in the patient’s immune system recognise the different antigens on he donor kidney and try to destroy them
21
Q

what are solutions to avoid kidney transplant failure

A
  • take immunosuppressant drugs for life (BUT harder to fight infectious diseases effectively)
  • make a close match by using similar tissue and blood type
22
Q

how long do transplanted kidneys averagely last

A

9-10 years

23
Q

what happens if a kidney transplant fails

A

patient has to return to dialysis and wait for another suitable kidney to be found

24
Q

advantages of dialysis

A
  • more readily available

- patient can lead a relatively normal life

25
Q

disadvantages of dialysis

A
  • monitor diet carefully
  • regular sessions on the machine
  • long term is expensive and damages body
26
Q

advantages of kidney transplant

A
  • free of restrictions that come from regular sessions and diet monitoring
27
Q

disadvantages of kidney transplant

A
  • shortage of donor kidneys (many don’t register as donors and less sudden car deaths)
28
Q

what is the hope for the future for kidney failure

A

grow functioning embryonic kidney tissue from stem cells perhaps even without antigens that trigger immune reaction

BIOLOGY chapter 15 (8 decks)

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