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Biology A2: 5.2 > 5.2.8: Kidney failure > Flashcards

5.2.8: Kidney failure Flashcards

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1
Q

What will kidney failure rapidly lead to death?

A

Because the kidneys will no longer be able to regulate the levels of water and electrolytes (substances that form charged particles in the water) in the body or to remove waste products such as urea from the blood. This will rapidly lead to death.

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2
Q

How can kidney function can be assessed?

A

-By estimating the glomerular filtration rate (GFR) and by analysing the urine for substances such as proteins.

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3
Q

What do Proteins in the urine indicate

A

-The filtration mechanism has been damaged.

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4
Q

What is the GFR is a measure of?

A

-How much fluid has passed into the nephrons each minute.

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5
Q

What is a normal GFR reading?

A

-In the range 90-120 cm3min-1.

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6
Q

What does a figure below 60cm3min-1 indicate?

A

-That there may be some form of chronic kidney disease.

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7
Q

What does a figure below 15cm3min-1 indicate?

A

-Kidney failure and a need for immediate medical attention.

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8
Q

What are the possible causes of kidney failure?

A

-Diabetes mellitus (both type 1 and 2 sugar diabetes) -Heart disease -Hypertension -Infection

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9
Q

What are the main treatments for kidney failure?

A

-Renal dialysis. (most common) -kidney transplant.

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10
Q

How are waste products, excess fluid and mineral ions are removed from the blood in renal dialysis?

A

-By passing it over a partially permeable dialysis membrane that allows the exchange of substances between the blood and dialysis fluid.

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11
Q

What does the dialysis fluid contain?

A

-The correct concentrations of mineral ions, urea, water and other substances found in the blood plasma.

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12
Q

How does renal dialysis regulate the levels of water and electrolytes in the blood?

A

-Any substances in excess in the blood diffuse across the membrane into the dialysis fluid. -Any substances that are too low in concentration diffuse into the blood from the dialysis fluid.

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13
Q

What are the two types of renal dialysis?

A

-Haemodialysis -Peritoneal dialysis (PD)

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14
Q

Describe the process of Haemodialysis.

A
  • Blood from an artery or vein is passed into a machine that contains an artificial dialysis membrane shaped to form many artificial capillaries.
  • The artificial capillaries are surrounded by dialysis fluid, which flows over in the opposite direction to the blood.
  • Any bubbles are removed before the blood is returned to the body via a vein.
  • Haemodialysis is usually performed at a clinic two or three times a week for several hours at each session. Some patients learn to carry it out a home.
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15
Q

Why is the dialysis membrane shaped to form many artificial capillaries? (haemodialysis)

A

-Increases the surface area for exchange.

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16
Q

Why is Heparin added? (haemodialysis)

A

-To avoid clotting.

17
Q

How is the efficiency of exchange improved in haemodialysis?

A

The dialysis fluid flows over in the opposite direction to the blood (countercurrent).

18
Q

How often and where is haemodialysis is usually performed?

A

-At a clinic two or three times a week for several hours at each session. Some patients learn to carry it out a home.

19
Q

In peritoneal dialysis, what acts as the dialysis membrane?

A

-The body’s own abdominal membrane (peritoneum).

20
Q

How does peritoneal dialysis work?

A

-First, a surgeon implants a permanent tube in the abdomen. -Dialysis solution is poured through the tube and fills the space between the abdominal wall and organs. -After several hours, the used solution is drained from the abdomen.

21
Q

Where can PD be carried out?

A

-At home or work, because the patient can walk around while having dialysis, -Sometimes called ambulatory PD.

22
Q

What must dialysis be combined with?

A

-A careffully monitored diet.

23
Q

How is a kidney transplant carried out?

A

-Patient is under anaesthesia. -Surgeon implants new organ into the lower abdomen and attaches it to the blood supply and the bladder.

24
Q

Why are patients given immunosuppressant drugs?

A

-To prevent their immune systems from recognising the new organ as a foreign object and rejecting it.

25
Q

What are the advantages of a kidney transplant?

A

-Freedom from time-consuming renal dialysis. -Feeling physically fitter. -Improved quality of life able to travel. -Improved self-image- no longer have a feeling of being chronically ill.

26
Q

What are the disadvantages of a kidney transplant?

A

-Need to take immunosuppressant drugs. -Need for major surgery under general anaesthetic. -Need for regular checks for signs or rejection. -Side-effects of immunosuppressant drugs.

27
Q

What is the side effects of immunosuppressant drugs?

A

-Fluid retention -High blood pressure -Susceptibility to infectoins.

28
Q

Molecules with a relative molecular mass of less than 69000 can enter the nephron. This means that Any metabolic product or other substance in the blood can, therefore, be passed into the urine if it is small enough. What happens if these substances are not reabsorbed further down the nephron?

A

They can be detected in urine.

29
Q

What can urine be tested for?

A

-Glucose in the diagnosis of diabetes. -Alcohol to determine blood alcohol levels in drivers. -Many recreational drugs. -Human chorionic gonadotrophin (hCG) in pregnancy testing. Anabolic steroids.

30
Q

What hormone does a human embryo produce once it is implanted in the uterine lining?

A

-Human chorionic gonadotrophin (hCG)

31
Q

What it human chorionic gonadotrophin and where can it be found?

A

A relatively small glycoprotein with a molecular mass of 36,700, -It can be found in the urine as early as six days after conception.

32
Q

What do pregnancy tests use to identify a pregnancy?

A

-Pregnancy-testing kits use monoclonal antibodies which bind to hCG in urine.

33
Q

-What are the steps in a pregnancy test?

A

-urine poured onto test stick. -hCG binds to mobile antibodies attached to a blue bead. -Mobile antibodies move down the test stick. -If hCG is present, it binds to fixed antibodies holding the bead in place- a blue line forms. -Mobile antibodies with no hCG bid to another fixed site to show the test is working. (two blue lines=pregnant)

34
Q

What do anabolic steroids do?

A

-They increase protein synthesis within cells. -This results in the build-up of cell tissue, especially in the muscles.

35
Q

Why are non-medical uses for anabolic steroids controversial?

A

-Because they give an advantage in competition. -They have dangerous side effects.

36
Q

What is the half-life of anabolic steroids?

A

-16 hours. -They remain in the blood for many days.

37
Q

Anabolic steroids are small molecules and enter the nephron easily. How can they be tested for?

A

-Analysing a urine sample in a laboratory using gas chromatography.

Biology A2: 5.2 (8 decks)

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