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Urinary - Conditions > Renal Dialysis > Flashcards

Renal Dialysis Flashcards

1
Q

what is RRT

A

renal replacement therapy (dialysis or transplant)

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2
Q

what is end-stage renal disease

A

irreversible kidney damage so severely affecting ability to remove waste or adjust blood that they need dialysis or transplant

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3
Q

the syndrome of advanced chronic kidney disease

A

uraemia

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4
Q

earliest cardinal symptoms of uraemia

A

malaise and fatigue

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5
Q

what stage of CKD can it remain asymptomatic till

A

stage 4 or 5

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6
Q

what eGFR would indicate RRT

A

<10ml.min

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7
Q

4 types of RRT

A

transplant, haemodialysis, peritoneal dialysis and conservative kidney management

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8
Q

signs of uraemia

A 
hyperpigmentation
pallor
hypertension
postural hypotension
peripheral oedema
LV hypertrophy
PVD
pleural effusion
peripheral neuropathy
restless legs syndrome
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9
Q

symptoms of uraemia

A 
anorexia
nausea
vomiting
fatigue
weakness
pruritus
lethargy
dyspnoea
insomnia
cramps
nocturia
polyuria
headace
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10
Q

what is CKD

A

chronic kidney disease –> proteinuria or haematuria and/or reduction in GFR for more than 3 months

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11
Q

most common causes of CKD

A

diabetes and hypertension

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12
Q

why is fatigue a symptom of CKD

A

because anaemia is present from the lack of erythropoietin produced once GFR<50ml/min

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13
Q

oedema in CKD is caused by

A

salt and water retention as GFR declines

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14
Q

pruritis, nausea and vomiting in CKD is thought to be caused by

A

accumulation of toxins

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15
Q

what key toxin is not excreted in CKD

A

urea

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16
Q

principle of haemodialysis

A

blood is pumped through a solute (dialysate) and a semipermeable membrane. The content is filtered by diffusion (solute concentration) and by ultrafiltration (pressure altering water content)

17
Q

what is constantly infused throughout haemodialysis

A

heparin (anticoagulant)

18
Q

what vascular structure is required for haemodialysis

A

an arteriovenous fistula

19
Q

4 things needed for dialysis

A
  1. a semipermeable membrane
  2. adequate blood exposure to membrane
  3. dialysis access
  4. anticoagulation (only haemo)
20
Q

what is the semipermeable membrane in peritoneal dialysis

A

the peritoneum

21
Q

restrictions in dialysis

A

reduced fluid intake (usually <1L/day) and dietary restriction of potassium sodium and phosphate

22
Q

what is the blood supply in PD

A

mesentric circulation

23
Q

principle of peritoneal dialysis

A

a dialysate is instilled through a catheter into the peritoneal cavity. The peritoneum acts as the membrane and after a time the fluid is drain out and replaced with new dialysate

24
Q

3 types of PD

A

continuous ambulatory, automated or a hybrid

25
Q

what is the most commonly used osmotic agent of PD

A

glucose

26
Q

which part of dialysis, diffusion or ultrafiltration, is glucose responsible for

A

ultrafiltration

27
Q

what varies in timing between CAPD and APD

A

CAPD is throughout the daytime

APD is through night

28
Q

complications of PD

A

infection of skin or peritoneum

encapsulating peritoneal sclerosis (extensive thickening and fibrosis of peritoneum creating a fibrous cocoon for bowel)

29
Q

if there is PD peritonitis with a gram positive microorganism, where is it’s origin

A

skin

30
Q

if there is PD peritonitis with a gram negative microorganism, where is it’s origin

A

bowel

31
Q

indications for dialysis

A

GFR 5-10ml/min
severe acidosis
treatment resistant hyperkalaemia
treatment resistant fluid overload

32
Q

which dialysis type is allowed more fluid intake

A

PD - fluid balance is more continuous

33
Q

main indication for dialysis

A

symptoms or uraemia or eGFR<10ml/min

34
Q

in haemodialysis urea and creatinine are moved into/removed from the blood

A

removed from the blood

35
Q

electrolyte movement in dialysis

A

not neccessarily removed or kept in, more just that they are brought to the right conc in blood

Urinary - Conditions (13 decks)

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