Renal replacement therapy Flashcards

1
Q

Describe the function of kidneys in activating vitamin D

A

The kidneys convert vitamin D into calcitrol which is it’s active form - this is crucial for calcium absorption and maintaining phosphorus levels in out blood, this ensures strong healthy bones

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2
Q

Describe the production of erythropoetin

A

The kidneys produce erythropoetin which stimulates production of red blood cells in the bone marrow
This is important in maintaining adequate oxygen levels in the body

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3
Q

What is the definition of end stage renal disease

A

When there is so much damage to a person’s kidney that it impairs the usual function of excretion of waste and other functions which makes the patient require dialysis or transplant to live healthy

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4
Q

What is uraemia

A

The syndrome of advanced chronic kidney disease

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5
Q

What are the cardinal symptoms of uraemia

A

Malaise and fatigue although the symptoms can affect almost every organ

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6
Q

When is renal replacement therapy indicated

A

When eGFR is less than 10

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7
Q

What are the different types of renal replacement therapy

A

Transplant
Haemodialysis - most common
Peritoneal dialysis
Conservative kidney management

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8
Q

What is conservative kidney management

A

For very old, frail individuals , dialysis may cause more harm than good so it is better suited that their symptoms get treated with medication

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9
Q

Define dialysis

A

A process where the solute composition of a solution A is modified by exposing another solution to solution A through a semipermeable membrane

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10
Q

What is required for dialysis

A

Semipermeable membrane which is meant to act as the filtration system of the kidney
Adequate blood supply to the machine
Dialysis access
Anticoagulation in haemodialysis

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11
Q

Where is the dialysis access in haemodialysis compared to peritoneal dialysis

A

Hameodialysis - vascular access
Peritoneal dialysis - peritoneal access

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12
Q

What restrictions are in place for dialysis patients

A

Fluid restrictions and dietary restriction to limit electrolytes coming through the diet

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13
Q

What are complications of haemodialysis

A

Arrhythmias, hypotension and cramps

Issues with coagulation - clotting of the vascular access and issues with the heparin

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14
Q

What is the most common osmotic agent in peritoneal dialysis to be used for ultrafiltration

A

Glucose and it’s high osmolarity is used to pull fluid out towards it

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15
Q

What are the complications of peritoneal dialysis

A

Infections - risk of bactria getting into the tube during drainage

Peritonitis

Encapsulating peritoneal sclerosis

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16
Q

What is the symptoms of peritoneal dialysis (PD) peritonitis

A

Abdominal pain and cloudy urine

17
Q

What is encapsulating peritoneal sclerosis

A

mesentery and peritoneum become thickened and calcified which causes abdominal pain and obstruction in the bowel - usually occurs in patients who have been on dialysis for more than 5 years

18
Q

What are the indications for dialysis in end stage renal disease

A

Advanced uraemia - advanced CKD - GFR 5-10

Severe acidosis with bicarbonate less than 10 mmol/l

Hyperkalaemia and fluid overload which is treatment resistant

19
Q

What drugs should be taken for anaemia associated with the iron loss caused by dialysis

A

Erythropoetin injections and IV iron supplements

20
Q

What drugs should be given for renal bone disease associated with dialysis

A

Calcitrol (activated vitamin D)
Phosphate binders with meals

21
Q

What anticoagulant is commonly given with dialysis

A

Heparin

22
Q

What is ultrafiltration

A

Forcing fluid across the membrane to move some fluid out from the blood