L15: Dialysis And Transplantation Flashcards
How many stages of chronic kidney disease is there
5
Which stage of chronic kidney disease is the worst
Stage 5
In stage 5 chronic kidney disease what is the patient not able to maintain
Water homeostasis
Electrolyte balance
Acid base
Excrete metabolic waste
What are the 3 main ways to replace kidney function
Dialysis
Transplantation
Palliative care
What are the 2 types of dialysis
Heamodialysis
Peritoneal
Which function of the kidney does dialysis not replace
Hormone production such as vitamin d and EPO for RBC production in the bone marrow
Does transplantation replace all the functions fo the kidney including the hormone production
Yes
What barrier is used to separate the blood and the dialysis fluid during dialysis
A semi permeable membrane
What are the 3 processes that the dialysis relies on for movement of substances across the semi permeable membrane
Diffusion
Osmosis
Mass transport
What is the semi permeable membrane that we use in haemodialysis
Haemodialysis membrane which is an artificial membrane in the tube
What is the semi permeable membrane that we use in peritoneal dialysis
Peritoneum
What is the peritoneum
Lining of the abdominal cavity
What happens to the substances when the kidney does not work
Accumulation if Water Sodium Urea Potassium Acidosis as you use of hco3-
What is inside the dialysis fluid
Water
Dectosal glucose
A bit of : sodium, potassium
Bicarbonate so it enters the blood and restores the ph
What sets the osmotic pressure to draw water to it inside the dialysis fluid
Decta glucose
Describe the movement of substances from the peritoneum to the dialysis fluid
Water flows down to dilute the glucose
Sodium, potassium and urea flow down concentration gradient via diffusion
Bicarbonate moves into the circulation
Where can patients use peritoneal dialysis
At home
Is the peritoneal dialysis permanent
Yes
How many years does the peritoneal dialysis work until the peritoneum wears out
10 years
What are the risk factors of peritoneal dialysis
Infection to the peritoneum e.g peritonitis
Describe how hemodialysis works
Takes blood out of the body then gives blood back to the patient through the vessels
Where can the patient carry out haemodialysis
In hospital
How many times a week does the patient have to attend to the hospital for hemodialysis
3 times a week for 4 hours
How do we restore ph using a dialysis
Give bicarbonate to the patient through the dialysate fluid
Who is peritoneal dialysis better for
Patient with Severe heart disease
Young patients
When do we start a patient on dialysis
Chronic kidney disease
Acute kidney injury
What are the problems with dialysis
Risk of infection Cardiac disease Anaemia Bone disease Malnutrition
In transplantation does the old kidney get taken out
No unless there is a reason to such as cancer
Where do we place the new kidney in transplantation
Iliac fossa
Which vessels to we join the kidney to
Iliac vessels
Who should have a transplant
Patients with stage 5 chronic kidney disease
People who are fit for surgery
Which patients should not have transplantation
Patients with:
Cardiac disease
Recurrent disease
Non compliance
What do we mean by recurrent disease
A disease that can appear onto the kidney again
What do we mean by patients who are non complaint
Patients who agree to do the treatment but do not do it
Where are kidneys in transplantation form
Patient donors: cardiac or cerebral death
Alive donors: friends and family, random person
How do we avoid rejection after a kidney transplant
Match: ABO blood group Match HLA Screen for donor antibodies Drugs such as immunosuppressants
