Common Renal Problems

Question 1

1. Diuresis (increase in urine output)

Answer 1

Diuretics are chemicals that increase output of urine:

• caffeine
• alcohol
• very high levels of blood glucose or blood urea

Question 2

2. Kidney failure

Answer 2

Kidney failure occurs when the kidneys stop working.

What causes kidney failure?

• an injury to the kidneys, including kidney stones
• streptococcus bacteria can cause an infection
• excessive use of certain drugs

Question 3

What are kidney stones

Answer 3

Insoluble stones called renal calculi

Caused by:

• too much calcium in the diet
• a decrease in water intake
• abnormally alkaline or acidic urine

Question 4

Types of trauma

Answer 4

1. Blunt forced trauma is a direct blow to the abdomen, best indicator of a blunt kidney injury is blood in the urine
2. A penetrating force trauma is when the skin is broken or could be more severe, eg a gunshot

Question 5

Kidney transplants

Answer 5

The long term solution to kidney failure is kidney transplants

Question 6

Main functions of the kidneys

Answer 6

The main function of the kidneys is to maintain homeostasis by controlling the composition and volume of body fluids. The kidneys:

1. Excrete nitrogenous waste in the form of urea and small amounts of uric acid and creatinine to prevent a build up of these toxic substances
2. With the help of the skin, are responsible for osmoregulation
3. Help maintain the pH of body fluids by excreting more or less hydrogen ions
4. Help to maintain the balance of ions in the body

Question 7

Dialysis

Answer 7

Kidney failure occurs when the kidneys stop working properly. The short term solution to kidney failure is to cleanse the blood artificially by means of dialysis, using a kidney machine

Question 8

What is dialysis

Answer 8

Is the movement of molecules between two solutions of different compositions down their concentration gradients

Question 9

How does a kidney machine work

Answer 9

• blood from an artery in the patients arm flows into a dialyser, and then back into the vein in the arm
• in the dialyser blood circulates through fine tubes made of selectively permeable membranes
• an important difference is that it has no nitrogenous waste
• waste substances are found in the blood plasma but not in the dialysis solution. These waste products will therefore diffuse from the blood plasma down a concentration gradient
• the dialysis solution is continuously replaced to keep the concentration gradients favourable

Question 10

Disadvantages of dialysis

Answer 10

• time consuming
• very expensive
• limits fluid intake
• connect remove potassium and phosphates, which can build up and be life threatening
• patient may feel ill
• can lead to bleeding problems

Question 11

How are the kidneys procured for kidney transplants

Answer 11

Many recipients never get the kidney they need because:

• the donor does not comply with the strict criteria
• the tissue and blood type of the donor and recipient are not compatible
• no one has signed agreement for the donor kidney to be transplanted
• the recipient has not had end-stage organ failure