Dialysis and Kidney Transplant Flashcards
What presentations indicate chronic kidney disease?
- shrunken kidneys
- stable, slow decline and then acute event
- high creatinine
What presentations indicate acute kidney injury?
- normal creatinine
- sudden onset
What problems can be caused by ibuprofen?
- tubule interstitial nephritis
- affects blood flow
What treatment could be considered for an acute event on CKD?
- depends on state of hydration
- electrolytes
Why is AKI and DVT associated?
- nephrotic syndrome
- prothrombotic
- DVT
What are the 2 different forms of dialysis?
- hemodialysis
- peritoneal dialysis
What happens in hemodialysis?
- patients blood into dialyzer
- semi-permeable membrane, waste products move into the dialysate
- leaves and re-enters the patient
What happens in peritoneal dialysis?
- freah dialysate enters the peritoneal cavity (between the 2 layers of the peritoneum)
- waste products leave the blood and enter the peritoneal cavity
- used dialysate leaves the body through a catheter
Where does hemodialysis occur?
requires dialysis centre visits (can now be preformed at home)
Where does peritoneal dialysis occur?
performed at home, overnight (saves travel)
How often is hemodialysis required?
3-4.5 hours of treatment, 3 times a week
How often is peritoneal dialysis required?
normally 7 days a week, weekend off if needed
What are the dietary constraints required in hemodialysis?
strict dietary constraints and salt/water intake restrictions
What are the dietary constraints required in peritoneal dialysis?
fewer and less strict constraints
How easily accessible is peritoneal dialysis?
- can travel easily
- day time exchanges can happen any where
What are the risks associated with peritoneal dialysis?
chance of infection due to catheter, or something like peritonitis
What is the access point needed for hemodialysis?
- ideally: arteriovenous fistula (operation under anaesthetic)
- tunnelled central venous line (risk of bacteraemia if infected)
What factors are considered in determining a candidate as a suitable live kidney donor?
- age
- blood type
- co-morbidities
- family history of kidney disease
- financial stability
- mental health Hx
- pregnancy
- match
- 2 healthy kidneys
What tests are run to ensure a suitable live kidney donor?
- US (normal size)
- GFR (normal function)
- no haematuria
- no proteinuria
- blood type compatibility
- HLA typing
- serum crossmatch
What happens in a kidney transplant?
- donor artery and recipient artery
- donor vein and recipient vein
- transplanted ureter and the recipients urinary bladder
Where is the kidney placed in a kidney transplant?
in a different anatomical position to native kidneys
What happens to the native kidneys in a kidney transplant?
can be left in, unless:
- infection
- tumour
- polycystic kidneys
What are the recommendations given to patients with a kidney transplant?
- exercise
- low salt diet
- healthy lifestyle
What are the things that should be avoided given to patients with a kidney transplant?
- no live vaccines
- raw food
- food contraindicated to immunosuppressants
- alcohol
- NSAIDS
- smoking
What can cause oedema?
- poor perfusion of the kidney
- prone to AKIs and changes in blood pressure and fluid balance
