CGIER 26 - Haemodialysis and dialysis dementia

Question 1

primary organs of excretion

Answer 1

skin
kidneys
lungs

Question 2

location of kidneys

Answer 2

beside the spin in your back within the ribcage

Question 3

size and colour of kidneys

Answer 3

small ~ 10cm long with reddish-brown colour

Question 4

what enters the kidney through the artery

Answer 4

all blood components

Question 5

what leaves the kidney and return to the blood through the vein

Answer 5

proteins
nutrients
water
some ions

Question 6

what leaves the kidney through the ureter

Answer 6

waste
controlled amounts of water
ions

Question 7

metabolic waste removed from kidney

Answer 7

urea
uric acid
creatinine

Question 8

what else do kidneys control directly and how?

Answer 8

controlling base - make or remove HCO3-

adjust levels of phosphate buffer

Question 9

how is uric acid produced

Answer 9

product of breakdown of purine nucleotides

Question 10

how is creatinine produced

Answer 10

by product of breakdown of creatine phosphate energy usage in muscle

Question 11

name of condition if blood is too acidic

Answer 11

acidosis

Question 12

name of condition if blood is too basic

Answer 12

alkylosis

Question 13

purpose of blood entering kidney

Answer 13

filter blood of excess fluid, waste products and unwanted chemicals in the body

Question 14

how much urine does the body produce each day

Answer 14

1.5 litres

Question 15

how can the body be impacted if the kidney is not working properly or is diseased?

Answer 15

build up of waste products in the system - life threatening

Question 16

how are kidney diseases treated?

Answer 16

with medication, dialysis or kidney transplant

Question 17

how can kidneys be impaired?

Answer 17

infections
poisoning
lesions
tumours
kidney stone formation
shock
circulatory problems

Question 18

what are the 2 most common causes of kidney disease

Answer 18

diabetes

high blood pressure

Question 19

what does diabetes and high blood pressure lead to?

Answer 19

uremic poisoning - build up of nitrogenous waste products that are usually excreted in the urin

Question 20

name 3 waste products that quantity of them that can be accumulated in 1 day

Answer 20

urea 21g/day
creatinine 1.8g/day
Uric acid 480mg/day

Question 21

consequences of accumulation of uric acid

Answer 21

gout or kidney stones

Question 22

how is gout formed?

Answer 22

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

Question 23

what is gout?

Answer 23

crystals of the salt precipitate in joints.- cause inflammation and pain
often lead to arthritis

Question 24

cause of kidney stones

Answer 24

salt of uric acid precipitate in kidneys

Question 25

what is chronic kidney diseases

Answer 25

progressive loss of kidney function can lead to kidney failure

Question 26

examples and causes of chronic kidney diseases

Answer 26

water retention -> oedema H+ increases -> acidosis Nitrogen waster build up -> uremia

Question 27

what can leaving chronic kidney diseases lead to?

Answer 27

Can lead to coma and eventually death

Question 28

what is oedema?

Answer 28

Abnormal accumulation of fluid beneath the skin in one or more cavities of the body

Question 29

what determines the amount of interstitial fluid accumulated beneath the skin in oedema?

Answer 29

determined by balance in fluid homeostasis increases secretion of fluid in interstitium or impaired removal of fluid

Question 30

sequence of events following chronic kidney disease

Answer 30

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

Question 31

what causes the retention of water that leads to oedema from kidneys

Answer 31

kidney failure - salt retention - water retention - oedema

Question 32

what %age of the function may be lost before a person is aware that the kidneys are failing

Answer 32

80% | this is called end stage renal failure

Question 33

ways to treat end stage renal failure

Answer 33

artificial kidney | haemodialysis

Question 34

haemodialysis

Answer 34

the removal of soluble waste products from the bloodstream by means of a membrane.

Question 35

what can and can't pass through the membrane in haemodialysis

Answer 35

soluble particles can diffuse through the membrane | plasma proteins and blood cells can't

Question 36

function of haemodialysis

Answer 36

replaces the dialysis function of kidney and uses artificial membrane to clean the blood

Question 37

how does haemodialysis work to remove the waste products bigger than or the same size as blood components needed to live and why?

Answer 37

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

Question 38

what must be taken into consideration and monitored when using dialysis?

Answer 38

anti-coagulent rate of blood flow blood pressure blood temperature

Question 39

how does haemodialysis work?

Answer 39

``` 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 ```

Question 40

key components in dialysate

Answer 40

``` sodium chloride calcium potassium magnesium mostly water ```

Question 41

why is concentration of components in dialysis important

Answer 41

high levels of sodium -> hypernatraemia improper levels of ca2+ and Mg2+ -> bone disease traces of Cu ->fatalities

Question 42

dialysis dementia

Answer 42

people on home dialysis become insane (1 in 10)

Question 43

symptoms of dialysis dementia

Answer 43

``` Stuttering and twitching, slurred speech, delusions, coma, death. ```

Question 44

causes of dialysis dementia

Answer 44

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