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Renal AM > Renal replacement therapy > Flashcards

Renal replacement therapy Flashcards

1
Q

When is dialysis normally considered?

A

eGFR <15 and patient symptomatic

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2
Q

What are the 2 main methods of dialysis?

A

Haemodialysis

Peritoneal dialysis

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3
Q

What are some advantages of haemodialysis? 2

A

Effective

3-4 dialysis free days a week

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4
Q

What are some disadvantages of haemodialysis? 2

A

In hospital several days a week for a few hours at a time

Diet and fluid restriction

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5
Q

What are some complications of haemodialysis? 4

A

Intra-dialytic hypotension
Arrythmia
Clotting of vascular access
Infection

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6
Q

What are the advantages of peritoneal dialysis?

A

More independence

Fewer restrictions on diet and fluid

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7
Q

What are the disadvantages of peritoneal dialysis?

A

Daily

Have to receive training

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8
Q

What are the complications of peritoneal dialysis?

A 
Exit site infection
Peritonitis
Ultrafiltration failure
Encapsulating peritoneal sclerosis
Hypotension
Hernia
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9
Q

What can cause peritonitis in peritoneal dialysis?

A

Gram + = skin

Gram - = bowel

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10
Q

What are the 2 types of donor?

A

Live donor

Cadaveric

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11
Q

What are some contraindications to transplant?

A 
Cancer
Cardiac dysfunction
Recurring conditions
HIV/AIDS
Frailty
BMI >35
Non compliance
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12
Q

What is the induction immunosuppression post transplant?

A

Basoliximab

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13
Q

What is the maintenance immunosuppression post transplant?

A

Tacrolimus + mycophenolate + prednisolone

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14
Q

What are the types of rejection in transplant?

A

Hyperacute- rare
Acute
Chronic

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15
Q

What is hyper acute rejection?

A

Within minutes of transplant

Donor specific antibodies lead to severe necrosis and thrombosis

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16
Q

What is acute rejection?

A

Rejection occurring anytime post transplant

Sudden decline in GFR

17
Q

What causes an early acute rejection?

A

Donor specific antigens

18
Q

What cause a late acute rejection?

A

Non compliance/inadequate immunosuppression

19
Q

What is a chronic rejection?

A

Gradual decline in GFR

20
Q

What are the acute risks of kidney transplant?

A

Intraop= bleeding, clots
Blocked ureter, urine leak
Infection

21
Q

What are the chronic risks of transplant?

A

Immunosuppression –> infection
Malignancy
Diabetes
Hypertension

22
Q

What infections are esp worrying with immunosuppression?

A

Cytomegalovirus= most common big one

BK virus

23
Q

What malignancies are esp common with immunosuppression?

A

Skin cancer
KAposi’s sarcoma
Lymphoma

Renal AM (15 decks)

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