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BRS YR2 > Dialysis and Kidney Transplant > Flashcards

Dialysis and Kidney Transplant Flashcards

1
Q

What presentations indicate chronic kidney disease?

A
  • shrunken kidneys
  • stable, slow decline and then acute event
  • high creatinine
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2
Q

What presentations indicate acute kidney injury?

A
  • normal creatinine
  • sudden onset
  • normal kidney size
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3
Q

What problems can be caused by ibuprofen?

A
  • tubule interstitial nephritis
  • affects blood flow
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4
Q

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

A
  • electrolytes
  • diuretics
  • dialysis
  • depends on state of hydration
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5
Q

Why is acute kidney injury (AKI) and DVT associated?

A
  • nephrotic syndrome
  • prothrombotic
  • DVT
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6
Q

What are the 2 different forms of dialysis?

A
  • hemodialysis
  • peritoneal dialysis
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7
Q

What happens in hemodialysis?

A
  • patients blood into dialyzer
  • semi-permeable membrane, waste products move into the dialysate
  • leaves and re-enters the patient
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8
Q

What happens in peritoneal dialysis?

A
  • fresh 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
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9
Q

Where does hemodialysis occur?

A
  • dialysis centre
  • at home
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10
Q

Where does peritoneal dialysis occur?

A

performed at home, overnight (saves travel)

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11
Q

How often is hemodialysis required?

A
  • 3-4.5 hours of treatment, 3 times a week
  • home = 5-7 times per week
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12
Q

How often is peritoneal dialysis required?

A

normally 7 days a week, weekend off if needed

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13
Q

What are the dietary constraints required in hemodialysis?

A

strict dietary constraints and salt/water intake restrictions

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14
Q

What are the dietary constraints required in peritoneal dialysis?

A

fewer and less strict constraints

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15
Q

How easily accessible is peritoneal dialysis?

A
  • can travel easily
  • day time exchanges can happen any where
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16
Q

What are the risks associated with peritoneal dialysis?

A

chance of infection due to catheter, or something like peritonitis

17
Q

What is the access point needed for hemodialysis?

A
  • ideally: arteriovenous fistula (operation under anaesthetic)
  • tunnelled central venous line (risk of bacteraemia if infected)
18
Q

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

A
  • age
  • blood type
  • co-morbidities
  • family history of kidney disease
  • financial stability
  • mental health Hx
  • pregnancy
  • match
  • 2 healthy kidneys
19
Q

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

A
  • US (normal size)
  • GFR (normal function)
  • no haematuria
  • no proteinuria
  • blood type compatibility
  • HLA typing
  • serum crossmatch
20
Q

What happens in a kidney transplant?

A
  • donor renal artery connected to recipient external iliac artery
  • donor renal vein connected to recipient external iliac vein
  • donor ureter connected to the recipients urinary bladder
21
Q

Where is the kidney placed in a kidney transplant?

A

in a different anatomical position to native kidneys

22
Q

What happens to the native kidneys in a kidney transplant?

A

can be left in, unless:

  • infection
  • tumour
  • polycystic kidneys
23
Q

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

A
  • exercise
  • low salt diet
  • healthy lifestyle
24
Q

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

A
  • no live vaccines
  • no raw eggs, meat, undercooked fish, unpasteurised cheese
  • food contraindicated to immunosuppressants (seville oranges, earl grey, grapefruit)
  • alcohol
  • NSAIDS
  • smoking
25
Q

What can cause oedema?

A
  • poor perfusion of the kidney
  • prone to AKIs and changes in blood pressure and fluid balance
26
Q

What else would be recommended for patients post transplant?

A
  • antibiotics
  • immunosuppressants
  • regular fluid intake
  • flu jabs
  • active lifestyle
  • manage blood pressure
  • use sunscreen
  • check skin and breasts for cancer
  • seek help for psychiatric disorders

BRS YR2 (67 decks)

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