Kidney failure

Question 1

Causes of kidney failure

Answer 1

-kidney infections (structure of podocytes and tubules themselves may be damaged or destroyed)
-raised b.p (damage structure of epithelial cells and basement membrane in B.C)
-genetic conditions (polycystic kidney disease)

Question 2

Kidney infection or high b.p causes

Answer 2

-protein in urine (b.m/podo damaged so no longer act as filters and large plasma proteins can pass into filtrate)
-blood in urine (filtering not working)

Question 3

Complete failure of kidneys…

Answer 3

…concentrations of urea and mineral ions build up in the body

Question 4

Kidney failure =

Answer 4

-loss of electrolyte balance (body cannot excrete sodium, potassium and chloride ions=osmotic imbalances in tissues and death)
-build-up of toxic urea in blood (poison cells)
-high blood pressure (control by maintaining water balance of blood)
-weakened bones (calcium/phosphorus balance in blood is lost)
-pain and stiffness in joints as abnormal proteins build up in blood
-anaemia (hormone erythopoietin=stimulates formation of red blood cells, reduce production causing tiredness and lethargy)

Question 5

GFR (glomerular filtration rate)

Answer 5

-Blood test measures level of creatine in the blood=a breakdown product of muscles and used for estimate
(cm^3/min)
-if levels are high =signal that kidneys are not working
-factors such as GFR decreases steadily with age and men usually have more muscle=more creatine

Question 6

Renal dialysis

Answer 6

Function of kidneys carried out artificially
-haemodialysis
-peritoneal dialysis

Question 7

Transplant

Answer 7

A new healthy kidney is put into body to replace the functions of the failed kidneys

Question 8

Haemodialysis

Answer 8

1.Blood leaves patient’s body from an artery and flows into dialysis machine between partially permeable dialysis membranes (mimic b.m)
2.On other side is the dialysis fluid
-contains normal plasma levels of glucose (no net movement)
-normal plasma level of mineral ions (excess move out by diffusion down conc gradient into dialysis fluid=restore electrolyte balance)
-no urea (steep conc gradient so net movement of urea)

Question 9

Blood and dialysis fluid flow in opposite directions…

Answer 9

…maintain countercurrent exchange system

Question 10

Patients with k.f…

Answer 10

…-attached o dialysis machine several times a week for many hrs
-manage diets carefully
-eat relatively little protein and salt
-monitor fluid intake

Question 11

Peritoneal dialysis

Answer 11

-inside body
-natural dialysis membranes formed by the lining of the abdomen
-dialysis fluid introduced into abdomen using catheter
-left for several hrs so urea and excess minerals can pass out
-fluid then drained off and discarded

Question 12

Transplant…

Answer 12

-healthy kidney from donor and blood vessels are joined and ureter of new kidney is inserted into bladder

Question 13

Risks and how to mitigate transplant

Answer 13

-rejection due to antigens on donor being foreign so destruction of new kidney
-close match made
-immunosuppresant drugs(cant respond effectively to infectious diseases)
-average 9-10 yrs transplant works