Kidney Failure Causes, Symptoms andTreatment

Question 1

How can doctors detect kidney failure?

Answer 1

-Analysis of Urine
-Estimate the GFR

Question 2

How can doctors detect kidney failure by analysing the urine?

Answer 2

Plasma proteins, glucose/amino acids and RBC’s would be present

Question 3

How would these be present in the urine?

Answer 3

By the basement membrane being damaged e.g. from high blood pressure

Question 4

What does GFR stand for?

Answer 4

Glomerular Filtrate Rate

Question 5

What is GFR?

Answer 5

How fast filtrate is leaving glomerular capillaries and entering bowman’s capsule

Question 6

What are the 3 ranges for the GFR?

Answer 6

Normal=90 to 120
Kidney Failure- <60
Medical Emergency/Death= < 15

Question 7

What happens to the GFR naturally and during pregnancy?

Answer 7

-Naturally decreases with age
-In pregnancy, increases by about 50% but this is normal

Question 8

What are the 5 causes of kidney failure?

Answer 8

-High blood pressure
-Genetics
-Diabetes
-Infection
-Heart disease

Question 9

How does high blood pressure cause kidney failure?

Answer 9

Forces plasma proteins through basement membrane which damages it

Question 10

How does diabetes cause kidney failure?

Answer 10

If not controlled can cause kidneys to fail as high level of glucose in blood

Question 11

How does infection cause kidney failure?

Answer 11

Causes inflammation in the cells of the kidney so selective reabsoption or ultra-filtration may not happen effectively

Question 12

What is the first symptom of kidney failure?

Answer 12

Urea building up in blood (uraemia) causing someone to vomit, weight loss and damage to CNS

Question 13

What is the second symptom of kidney failure?

Answer 13

Decrease in osmoregulation and electrolyte regulation which can cause swelling (odema)

Question 14

What is the third symptom of kidney failure?

Answer 14

Decrease in erythropoietin (EPO) which is a hormone released by healthy kidneys that stimulates bone marrow to produce RBC’s (can cause anaemia)

Question 15

What are the 2 treatments for kidney failure?

Answer 15

-Transplant
-Dialysis

Question 16

Transplant work for kidney failure

Answer 16

-Old kidney is left in so have 3
-Normally from a living relative/match
-Have to take immunosuppressants to decrease risk of rejection
-Best long term solution unless really old

Question 17

What are the two types of dialysis?

Answer 17

-Peritoneal
-Haemodialysis

Question 18

Haemodialysis for kidney failure

Answer 18

-Often done while waiting for transplant or can’t have transplant e.g. too old
-4 to 5 hours, 2 to 3 times a week
-In a hospital/clinic
-Feel progressively worse between treatments as toxins build up

Question 19

How does haemodialysis work?

Answer 19

-Blood from artery is mixed with anticoagulants and enters catheter of machine and blood is then pumped back out by a vein
-toxins diffuse through a partially permeable membrane in the catheter into the dialysis fluid

Question 20

What do anticoagulants do?

Answer 20

Decrease risk of blood clots

Question 21

What does dialysis fluid contain?

Answer 21

-Glucose and amino acids in same concentration as healthy plasma
-Urea and ions in very low concentration

Question 22

What does the urea and ions in very low concentration do?

Answer 22

Gives low water potential so no osmosis happens stopping H2O from going to blood

Question 23

Why is the dialysis fluid constantly refreshed?

Answer 23

To maintain concentration gradeint

Question 24

How else is a concentration gradient maintained?

Answer 24

Dialysis fluid is pumped in and out by a counter current