L15-Dialysis and transplant

Question 1

In stage 5 of chronic kidney disease what mechanisms will you be unable to maintain?

Answer 1

Water homeostasis
Electrolyte homeostasis
Acid/base homeostasis
Excrete metabolic waste products

Question 2

How does dialysis work?

Answer 2

By separating the patients blood and the dialysis fluid by a semi-permeable membrane that allows solutes to transfer.
Not as good as real kidney as it only allows <15 mls/min

Question 3

What are the two types of dialysis and what are the semi-permeable membranes that they use?

Answer 3

haemodialysis- involves a thin semi-permeable membrane outside of body
Peritoneal dialysis-uses the peritoneum as the semi-permeable membrane

Question 4

What does peritoneal dialysis require to be put into the patient?

Answer 4

A permanent peritoneal catheter

Question 5

What are the two types of peritoneal dialysis?

Answer 5

Continuous dialysis where the patient will fill and drain their peritoneum throughout the day
Overnight dialysis where the patient is attached to a dialysis machine that does it for them overnight

Question 6

What does haemodialysis require to be put into the patient?

Answer 6

A permanent AV fistula

Question 7

How often must haemodialysis be done?

Answer 7

4 hours 3 times a week

Question 8

Why is an alkali buffer added to the dialysis solution?

Answer 8

H+ is only present in low concentrations in the blood so cannot diffuse itself to be filtered. So requires an alkali buffer that is in greater concentration than the alkali in the plasma

Question 9

Where is a kidney usually transplanted into?

Answer 9

The illiac fossa

Question 10

What are the two kinds of immune response that can cause rejection of a transplanted organ?

Answer 10

Either antibody mediated where antibodies cause an effector responce
Or Full CD4 immune reaction in which plasma cells will be produced