CGIER 26 - Haemodialysis and dialysis dementia Flashcards
primary organs of excretion
skin
kidneys
lungs
location of kidneys
beside the spin in your back within the ribcage
size and colour of kidneys
small ~ 10cm long with reddish-brown colour
what enters the kidney through the artery
all blood components
what leaves the kidney and return to the blood through the vein
proteins
nutrients
water
some ions
what leaves the kidney through the ureter
waste
controlled amounts of water
ions
metabolic waste removed from kidney
urea
uric acid
creatinine
what else do kidneys control directly and how?
controlling base - make or remove HCO3-
adjust levels of phosphate buffer
how is uric acid produced
product of breakdown of purine nucleotides
how is creatinine produced
by product of breakdown of creatine phosphate energy usage in muscle
name of condition if blood is too acidic
acidosis
name of condition if blood is too basic
alkylosis
purpose of blood entering kidney
filter blood of excess fluid, waste products and unwanted chemicals in the body
how much urine does the body produce each day
1.5 litres
how can the body be impacted if the kidney is not working properly or is diseased?
build up of waste products in the system - life threatening
how are kidney diseases treated?
with medication, dialysis or kidney transplant
how can kidneys be impaired?
infections poisoning lesions tumours kidney stone formation shock circulatory problems
what are the 2 most common causes of kidney disease
diabetes
high blood pressure
what does diabetes and high blood pressure lead to?
uremic poisoning - build up of nitrogenous waste products that are usually excreted in the urin
name 3 waste products that quantity of them that can be accumulated in 1 day
urea 21g/day
creatinine 1.8g/day
Uric acid 480mg/day
consequences of accumulation of uric acid
gout or kidney stones
how is gout formed?
uric acid + sodium ions = sodium urate - salt of uric acid
when the rate of formation of sodium urate is greater than the rate of elimination of sodium urate gout is formed
what is gout?
crystals of the salt precipitate in joints.- cause inflammation and pain
often lead to arthritis
cause of kidney stones
salt of uric acid precipitate in kidneys
what is chronic kidney diseases
progressive loss of kidney function can lead to kidney failure
examples and causes of chronic kidney diseases
water retention -> oedema
H+ increases -> acidosis
Nitrogen waster build up -> uremia
what can leaving chronic kidney diseases lead to?
Can lead to coma and eventually death
what is oedema?
Abnormal accumulation of fluid beneath the skin in one or more cavities of the body
what determines the amount of interstitial fluid accumulated beneath the skin in oedema?
determined by balance in fluid homeostasis
increases secretion of fluid in interstitium or
impaired removal of fluid
sequence of events following chronic kidney disease
progressive loss of kidney function
kidney failure
decrease in glomerular filtration rate
kidneys unable to maintain homeostasis of blood
Homeostatic balance of water, sodium, potassium, calcium & other salts no longer possible
Nitrogenous wastes not excreted
what causes the retention of water that leads to oedema from kidneys
kidney failure - salt retention - water retention - oedema
what %age of the function may be lost before a person is aware that the kidneys are failing
80%
this is called end stage renal failure
ways to treat end stage renal failure
artificial kidney
haemodialysis
haemodialysis
the removal of soluble waste products from the bloodstream by means of a membrane.
what can and can’t pass through the membrane in haemodialysis
soluble particles can diffuse through the membrane
plasma proteins and blood cells can’t
function of haemodialysis
replaces the dialysis function of kidney and uses artificial membrane to clean the blood
how does haemodialysis work to remove the waste products bigger than or the same size as blood components needed to live and why?
contain a semi permeable membrane and an isotonic solution of the ions and components we want to keep in the blood called a dialysate solution where we continuously replenish the dialysate solution so we never have a build up of waste products to disrupt the equilibrium and prevent waste products to move back into the blood
what must be taken into consideration and monitored when using dialysis?
anti-coagulent
rate of blood flow
blood pressure
blood temperature
how does haemodialysis work?
blood passes from artery through long coiled cellophane tube - dialysing membrane anti-coagulent heparin is used patients receive iron and calcium intravenously to increase blood cell prod. dialysate solution (isotonic solution of essential blood and essential components as big as waste products) circulates outside cellophane tube
key components in dialysate
sodium chloride calcium potassium magnesium mostly water
why is concentration of components in dialysis important
high levels of sodium -> hypernatraemia
improper levels of ca2+ and Mg2+ -> bone disease
traces of Cu ->fatalities
dialysis dementia
people on home dialysis become insane (1 in 10)
symptoms of dialysis dementia
Stuttering and twitching, slurred speech, delusions, coma, death.
causes of dialysis dementia
aluminium poisoning - high aluminium water supply
dialysis exposed blood to large volumes of water containing large amounts of aluminium
people on dialysis can’t excrete Al properly
