Dialysis and kidney transplant

Question 1

what are the types of dialysis?

Answer 1

hemodialysis

peritoneal dialysis

Question 2

how does haemodialysis work?

Answer 2

• Blood from patient’s body
• Through dialyzer using a semipermeable membrane
• Used dialysate removed
• Counter current mechanism between fresh filtrate and blood
• Clean blood goes back into patients body

Question 3

what does haemodialysis require routine wise?

Answer 3

1. Requires dialysis centre visits (Can be performed at home also)
2. 3-45 hours of treatment 3x week (4 treatment free days)
3. Strict dietary constraints and salt/water intake restrictions
4. Needs access- arteriovenous fistula (operation under local) or tunnelled central venous line (risk bacteraemia if infected)

Question 4

how does peritoneal dialysis work?

Answer 4

1. Dialysate entered into peritoneal cavity
   
   1. Using catheter
   2. Used dialysate removed from perineal as fresh pumped in

Question 5

what does peritoneal dialysis require routine wise?

Answer 5

1. Performed at home overnight
2. 7 days a week but often have weekend off if needed
3. Lesser constraints for food and water intake
4. Can travel easily
5. Day time exchanges can be done anywhere- just need to be able to wash hands
6. Change of infection due to catheter as peritonitis

Question 6

what are the factors to consider with a living kidney donor?

Answer 6

Question 7

how is a kidney transplanted?

Answer 7

• Doner artery and vein connected to recipient artery and vein
• Transplanted ureter connected to recipient urinary bladder
• Different anatomical locations to native kidneys

Question 8

what are the general recommendations post-transplant surgery?

Answer 8

• No NSAIDS/ herbal medicines
• No recreational drugs
• No smoking
• No alcohol
• No live vaccines
• Have flu jabs
• Antibiotics- check with pharmacist
• Immunosuppresive medications for life

Question 9

what are the food and water recommendations post transplant surgery?

Answer 9

• Regular fluid intake
• No raw eggs, raw meat, undercooked fish, unpasteurised cheese
• No food items that can interact with tacrolimus (immunosuppressant)
  
  • Seville oranges
  • Marmalade made form Seville O
  • Earl grey tea
  • grapefruit

Question 10

what are the recommendations to limit risk factor increases post transplant surgery?

Answer 10

• Diabetes
  
  • Active lifestyle and low salt/sugar diet
• Cardiovascular disorders
  
  • Manage and measure BP
• Cancer
  
  • Use sunscreen and cover up
  • Regular skin, breast checks
• Psychiatric disorders
  
  • Be mindful & seeking help