L32 Renal Replacement Therapy

Question 1

What are the advantages of haemodialyisis?

Answer 1

• Less protein lost
• Shorter treatment times
• Community at dialysis centre

Question 2

What are the advantages of peritoneal dialysis?

Answer 2

• More independence as can be done at home
• No anti-coagulation
• Less fluid restriction
• No need for vascular access
• Preservation of residual renal function

Question 3

What are the disadvantages of haemodialyisis?

Answer 3

• Less independent as a very small population do it at home
• More fluid restriction
• HAeemodynatic stress
• Post dialysis hypotension
• Risk of infection at fistula and hypotension

Question 4

What are the disadvantages of peritoneal dialysis?

Answer 4

• Diastylate has a higher glucose concentration
• More protein Lost
• Risk of hernias and peritonitis
• Membarne failure - peritoneal dialysis only works for so long
• Risk of hyperglycaemia as glucose from diastylate can pass over into the blood stream

Question 5

Where is the new kidney transplanted?

Answer 5

In the lilac region - it is anastomosed with the iliac vein.

Question 6

What are the longer term side effects of kidney transplant?

Answer 6

Skin Cancer
• Avoid direct sun light, use of sun screen
Post Transplant Lymphoproliferative Disorder (PTLD)
• Weight loss
• Fever
• Lymphadenopathy
Opportunistic infections 
• Cytomegalovirus (CMV)
Pneumocystis Carinii Pneumonia (PCP)