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REN > L15: Dialysis And Transplantation > Flashcards

L15: Dialysis And Transplantation Flashcards

1
Q

How many stages of chronic kidney disease is there

A

5

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2
Q

Which stage of chronic kidney disease is the worst

A

Stage 5

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3
Q

In stage 5 chronic kidney disease what is the patient not able to maintain

A

Water homeostasis
Electrolyte balance
Acid base
Excrete metabolic waste

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4
Q

What are the 3 main ways to replace kidney function

A

Dialysis
Transplantation
Palliative care

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5
Q

What are the 2 types of dialysis

A

Heamodialysis

Peritoneal

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6
Q

Which function of the kidney does dialysis not replace

A

Hormone production such as vitamin d and EPO for RBC production in the bone marrow

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7
Q

Does transplantation replace all the functions fo the kidney including the hormone production

A

Yes

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8
Q

What barrier is used to separate the blood and the dialysis fluid during dialysis

A

A semi permeable membrane

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9
Q

What are the 3 processes that the dialysis relies on for movement of substances across the semi permeable membrane

A

Diffusion
Osmosis
Mass transport

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10
Q

What is the semi permeable membrane that we use in haemodialysis

A

Haemodialysis membrane which is an artificial membrane in the tube

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11
Q

What is the semi permeable membrane that we use in peritoneal dialysis

A

Peritoneum

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12
Q

What is the peritoneum

A

Lining of the abdominal cavity

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13
Q

What happens to the substances when the kidney does not work

A 
Accumulation if
Water
Sodium 
Urea
Potassium 
Acidosis as you use of hco3-
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14
Q

What is inside the dialysis fluid

A

Water
Dectosal glucose
A bit of : sodium, potassium
Bicarbonate so it enters the blood and restores the ph

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15
Q

What sets the osmotic pressure to draw water to it inside the dialysis fluid

A

Decta glucose

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16
Q

Describe the movement of substances from the peritoneum to the dialysis fluid

A

Water flows down to dilute the glucose
Sodium, potassium and urea flow down concentration gradient via diffusion
Bicarbonate moves into the circulation

17
Q

Where can patients use peritoneal dialysis

A

At home

18
Q

Is the peritoneal dialysis permanent

A

Yes

19
Q

How many years does the peritoneal dialysis work until the peritoneum wears out

A

10 years

20
Q

What are the risk factors of peritoneal dialysis

A

Infection to the peritoneum e.g peritonitis

21
Q

Describe how hemodialysis works

A

Takes blood out of the body then gives blood back to the patient through the vessels

22
Q

Where can the patient carry out haemodialysis

A

In hospital

23
Q

How many times a week does the patient have to attend to the hospital for hemodialysis

A

3 times a week for 4 hours

24
Q

How do we restore ph using a dialysis

A

Give bicarbonate to the patient through the dialysate fluid

25
Q

Who is peritoneal dialysis better for

A

Patient with Severe heart disease

Young patients

26
Q

When do we start a patient on dialysis

A

Chronic kidney disease

Acute kidney injury

27
Q

What are the problems with dialysis

A 
Risk of infection
Cardiac disease
Anaemia 
Bone disease 
Malnutrition
28
Q

In transplantation does the old kidney get taken out

A

No unless there is a reason to such as cancer

29
Q

Where do we place the new kidney in transplantation

A

Iliac fossa

30
Q

Which vessels to we join the kidney to

A

Iliac vessels

31
Q

Who should have a transplant

A

Patients with stage 5 chronic kidney disease

People who are fit for surgery

32
Q

Which patients should not have transplantation

A

Patients with:
Cardiac disease
Recurrent disease
Non compliance

33
Q

What do we mean by recurrent disease

A

A disease that can appear onto the kidney again

34
Q

What do we mean by patients who are non complaint

A

Patients who agree to do the treatment but do not do it

35
Q

Where are kidneys in transplantation form

A

Patient donors: cardiac or cerebral death

Alive donors: friends and family, random person

36
Q

How do we avoid rejection after a kidney transplant

A 
Match:
ABO blood group 
Match HLA
Screen for donor antibodies 
Drugs such as immunosuppressants

REN (19 decks)

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