Kidney disease Flashcards
Main causes of kidney disease? 6
High blood press
Infection
Loss of blood pressure
Auto immune disease
Crushing injuries
Diabetes
How does high bp cause kidney disease
Damage to glomerular capillaries, prevents ultrafiltration
Auto immune disease
When the body makes antibodies against it’s own tissues
What can cause loss of blood pressure 2
Dehydration
Blood loss
Treatments for kidney disease 4
Low protein diet (reduce urea formation)
Drugs
Dialysis
Transplant
How do calcium channel blockers treat kidney diseases?
Dialate blood vessels to reduce the pressure of the blood flowing through them
How do beta blockers treat kidney disease?
Reduce affects of adrenalin (which increases heart rate and thus blood pressure)
How do ACE inhibitors and ARBs react kidney disease
Reduce the affect of the hormone angiotensin which causes blood vessel constriction (so would increase blood pressure in vessels)
What does ACE inhibitors stand for
Angiotensin converting enzyme
What does ARBs stand for
Angiotensin receptor blockers
Affect of kidney disease on conc of K+ and Ca2+
Increases the blood conc of both
Treatment for hight blood potassium 3
Glucose, insulin
Intravenous calcium to stabilise heart muscle membranes
Affect of increased blood calcium conc
High blood calcium conc increased risk of heart disease, kidney stones, osteoporosis
Deposition of Ca salts in tissues
Affect of high blood potassium conc
High blood potassium conc
Caused heart arrhythmias (irregular heart beat)
Treatment for high blood conc of calcium
Bisphosphates used to decrease the activity of cells that break down bone causing calcium to be released into the blood
Drugs cause calcium to accumulate in ones rather than blood
Kidney transplant from live vs deceased donors
Live begins to work immediately, Dead may no so patient req dialysis initially
Live last longer
High risk donors?
Ppl overr 50
with high blood pressure
with diabetes
What are the criteria for a transplant to work
Donor and recipient must be ABO blood group compatible and a close tissue match in HLA
HLA
Human Leucocyte Antigens
Xenotransplantation
Animals e.g pigs could be genetically engineered so their cells do not carry the antigens that would be attacked by our immune system.
However there are ethical issues
Where is blood taken from in haemodialysis
Vein in the arm
By what mechanisms is rate of diffusion increased in haemodialysis 2
Counter current flow of blood and dialysis fluid within the machine
Fresh fluid so CONSTANTLY moving through machine and used fluid removed
Conc of solutes in dialysate and pore size of membranes can be adjusted
To what type of blood vessel is the cleaned blood returned in haemodialysis
Vein
Function of heparin
Added to blood to thin it and prevent clotting
Describe the components and concentrations of dialysis fluid 4
Isotonic with blood
Low ion conc
No urea
Normal blood glucose conc
What does CAPD stand for
Continuous Ambulatory Peritoneal Dialysis
Peritoneum? 2
Layer of tissue lining the abdomen
Has dense capillary network, acts as a dialysis membrane
How does dialysis fluid meet the blood in CAPD
Catheter inserted into abdominal cavity, dialysis fluid is passed into cavity
After how long is the dialysis fluid drained in CAPD and how
After 40mins
Using gravity, fluid is collected in an empty bag
How often must dialysis fluid be changed in CAPD
4 times daily
Drawback of CAPD
Liquid retention occurs so patient must drink little
K+ ions accumulate in blood so patient must avoid high potassium foods
Comparable points between haemodialysis and CAPD 7
Time
Mobility
Req hospital visits?
Cost of machinery
Risk of fluctuations in blood vol and content
Efficiency in removing excess salt and water
Risk of infection
How long must transplant patients take immunosurpressants for
Life long
Risk of taking immunosuppressive drugs
Patients are more susceptible to infection, especially of the urinary tract (can damage kidney)
Low dose antiviral can be used long term to prevent infection by..
..cytomegalovirus
Risk of a high protein diet 3
Increased urea levels, converted to uric acid
Crystallize》kidney stones which tear tissues
Specific affects of kidney stones
Small proteins are able to be excreted by the kidneys into the filtrate
leads to accumulation of tissue fluids in tissues bc of shift in osmotic pressures
Affect of high glomerular pressure 3
Damage to glomeruli
Excessive filtration
Loss of nutrients / cells+ plasma proteins in urine
osteoporosis
Brittle bone disease
structure of dialysis machine
System of dialysis tubing bathed in dialysis fluid
Why does high blood Ca conc cause osteoporosis
Ca is in the blood rather than bones causing brittle bones
Sensitized?
Someone who has already had a transplant.
More likely to produce antibodies against antigens on donor organ
What is the only solution for inherited conditions causing kidney disease
Transplant
2 Categoiries of kidney failure
Acute or Chronic
