Dialysis and Kidney Transplant

Question 1

What presentations indicate chronic kidney disease?

Answer 1

• shrunken kidneys
• stable, slow decline and then acute event
• high creatinine

Question 2

What presentations indicate acute kidney injury?

Answer 2

• normal creatinine

- sudden onset

Question 3

What problems can be caused by ibuprofen?

Answer 3

• tubule interstitial nephritis

- affects blood flow

Question 4

What treatment could be considered for an acute event on CKD?

Answer 4

• depends on state of hydration

- electrolytes

Question 5

Why is AKI and DVT associated?

Answer 5

• nephrotic syndrome
• prothrombotic
• DVT

Question 6

What are the 2 different forms of dialysis?

Answer 6

• hemodialysis

- peritoneal dialysis

Question 7

What happens in hemodialysis?

Answer 7

• patients blood into dialyzer
• semi-permeable membrane, waste products move into the dialysate
• leaves and re-enters the patient

Question 8

What happens in peritoneal dialysis?

Answer 8

• 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

Question 9

Where does hemodialysis occur?

Answer 9

requires dialysis centre visits (can now be preformed at home)

Question 10

Where does peritoneal dialysis occur?

Answer 10

performed at home, overnight (saves travel)

Question 11

How often is hemodialysis required?

Answer 11

3-4.5 hours of treatment, 3 times a week

Question 12

How often is peritoneal dialysis required?

Answer 12

normally 7 days a week, weekend off if needed

Question 13

What are the dietary constraints required in hemodialysis?

Answer 13

strict dietary constraints and salt/water intake restrictions

Question 14

What are the dietary constraints required in peritoneal dialysis?

Answer 14

fewer and less strict constraints

Question 15

How easily accessible is peritoneal dialysis?

Answer 15

• can travel easily

- day time exchanges can happen any where

Question 16

What are the risks associated with peritoneal dialysis?

Answer 16

chance of infection due to catheter, or something like peritonitis

Question 17

What is the access point needed for hemodialysis?

Answer 17

• ideally: arteriovenous fistula (operation under anaesthetic)
• tunnelled central venous line (risk of bacteraemia if infected)

Question 18

What factors are considered in determining a candidate as a suitable live kidney donor?

Answer 18

• age
• blood type
• co-morbidities
• family history of kidney disease
• financial stability
• mental health Hx
• pregnancy
• match
• 2 healthy kidneys

Question 19

What tests are run to ensure a suitable live kidney donor?

Answer 19

• US (normal size)
• GFR (normal function)
• no haematuria
• no proteinuria
• blood type compatibility
• HLA typing
• serum crossmatch

Question 20

What happens in a kidney transplant?

Answer 20

• donor artery and recipient artery
• donor vein and recipient vein
• transplanted ureter and the recipients urinary bladder

Question 21

Where is the kidney placed in a kidney transplant?

Answer 21

in a different anatomical position to native kidneys

Question 22

What happens to the native kidneys in a kidney transplant?

Answer 22

can be left in, unless:

• infection
• tumour
• polycystic kidneys

Question 23

What are the recommendations given to patients with a kidney transplant?

Answer 23

• exercise
• low salt diet
• healthy lifestyle

Question 24

What are the things that should be avoided given to patients with a kidney transplant?

Answer 24

• no live vaccines
• raw food
• food contraindicated to immunosuppressants
• alcohol
• NSAIDS
• smoking

Question 25

What can cause oedema?

Answer 25

• poor perfusion of the kidney

- prone to AKIs and changes in blood pressure and fluid balance