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Urinary System > Renal Replacement Therapy > Flashcards

Renal Replacement Therapy Flashcards

1
Q

Where is transplanted kidney placed ?

A

Iliac fossa where it is anastamosed into iliac vessels

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2
Q

What is indicative for a native nephrectomy to be carried out?

A

Polycystic kidneys - increase size

Infection

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3
Q

What are complications of transplant surgery?

A

Bleeding, arterial thrombosis, venous thrombosis, lymphocele

Urine leak

Infection

Rejection

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4
Q

Name some immunosupressive agents?

A

Corticosteroids, calcineurin inhibitors, anti-proliferative, mTOR inhibitors (sirolimus), costimulatory signal blockers, depleting agents

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5
Q

What are the side effects of corticosteroids?

A

Hypertension, hyperglycaemia, infections, bone loss, GI bleeding

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6
Q

What are side effects of tacrolimus?

A

Hyperglycaemia, AKI, tremor

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7
Q

Name the side effects of cyclosporin?

A

Hirsuitism, hypertension, AKI, gout

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8
Q

What are the side effects of sirolimus?

A

Lipodogenic, diabetogeinic, pneumonia

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9
Q

What are the complications after renal transplantation?

A

Rejection

Infection

Cardiovascular - CRF, Hypertension, hyperlipidaemia, Post Trauma Diabetes

Malignancy

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10
Q

What is cytomegalovirus?

A

A transplant related infection

Associated with high mortality and morbidity if untreated

It is either transmitted from donor tissue or reactivated from a latent state

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11
Q

What is BK virus?

A

A branch of polyomaviridae

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12
Q

What is the effect of BK virus on kidney transplant patients?

A

Manifests as Ureteral Stenosis, Intestinal Nephritis or ESRF

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13
Q

What is the outcome of BK virus on kidney transplant patients?

A

Allograft dysfunction or loss of graft

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14
Q

What is the treatment for BK virus?

A

Reduce immunosupression

Anti Viral Therapy

  • cidofovir
  • leflunomide
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15
Q

What is end stage renal disease ?

A

Irreversible damage to a persons kidneys affecting their ability ro remove or adjust blood waste thus, to maintain life, they must have a kidney transplant

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16
Q

What are the clinical features of CKD?

A

Until stage 4/5, patient is asymptomatic

Advanced CKD = Uraemia
- cardinal symptom = malaise and fatigue

17
Q

Name the types of renal replacement therapy

A

Renal transplant, haemodialysis, peritoneal dialysis, conservative kidney maagement

18
Q

When would conservative kidney management be an appropriate choice of treatment?

A

During end stage kidney disease when body isn’t coping with dialysis (i.e cardiovascular stress)

Permits more time at home for patient

19
Q

What is dialysis ?

A

a process by which solute composition of solution A is altered by exposure to solution B through a semi permeable membrane

20
Q

What are the access points for haemodialysis?

A

AV fistula/graft

Tunneled/temporary venous catheter

21
Q

What is the process of ultrafiltration?

A

Removal of excess fluid

22
Q

When are prosthetic grafts used ?

A

When blood vessels have calcified or when blood vessels are small

23
Q

What are the restrictions placed on dialysis patients?

A

Fluid restriction

  • dictated by residual urine ouput
  • interdialytic weight gain

Dietary Restriction
-Potassium
-Sodium
Phosphate

24
Q

What are the complications of peritoneal dialysis?

A

Exit site infection
PD peritonitis
Ultrafiltration failure
Encapsulating peritoneal sclerosis

25
Q

What is a gram positive cause of PD peritonitis?

A

Skin contaminant

26
Q

What is a gram negative cause of PD peritonitis?

A

Bowel origin

27
Q

What kind of bacteria would be found in peritonitis caused by perforation?

A

Mixed positive and negative

28
Q

What will dialysis patients develop in between dialysis?

A

Hyperkalaemia and acidosis

29
Q

What is the most common cause of death in dialysis patients?

A

CVD or infection

30
Q

Who would not benefit from Peritoneal Dialysis?

A

Patients with a decreased urine output

31
Q

What colour is PD fluid?

A

clear

infection = cloudy

32
Q

What are indications for dialysis in ESRD?

A

Advanced uraemia, severe acidosis, treatment resistance hyperkalaemia, treatment resistant fluid overload

33
Q

What are complications from haemodialysis?

A

Cardiovascular problems
- hypotension, cramps and arrythmias

Coagulation

  • clotting of vascular access
  • heparin related problems

Allergic reactions to dialysers and tubing

34
Q

What are complications of PD?

A

Infection
- exit site infection, tunnel infection, peritonitis

Mechanical
-Tube malfunction, abdominal wall hernia

Ultrafiltration problems

Urinary System (15 decks)

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