Renal Replacement Therapy Flashcards
What are the renal functions
excretory function
water and electrolyte balance
acid base balance
renal endocrine function
What are the renal endocrine functions
erythropoietin
calcium metabolism
renin secretion
Is renal dialysis an active or passive process
Passive
How is renal dialysis passive
it is diffusion across concentration gradients
What does renal dialysis allow
intermittent correction of changes in plasma concentration of small molecules
What are the 2 types of renal dialysis
haemodialysis
peritoneal dialysis
What is hemodialysis
blood taken to outside the body, filtered and returned
What is peritoneal dialysis
inside the body
utilizes the inside layers of the peritoneum which has an exposed layer of BV
What happens in dialysis
There are holes which are not big enough to allow RBC and proteins through but allows electrolyte exchange
How do you allow for dialysis to be a passive process
The solution put in the machine should be what you want in the blood
You need to make a concentration gradient
What is the heparin pump for
Stop blood clotting in machine
What happens in peritoneal dialysis
The fluid is pumped into the peritoneal space
exchange occurs and the fluid and waste products are drained from the peritoneal space
What does peritoneal dialysis allow for
Much more flexibility
How is erythropoietin replaced
by EPO injections
maintains red cell mass
How is bone mass maintenance replaced
Vitamin D supplementation
osteoporosis prevention programme
How can hypertension control be an issue in renal disease
the renin angiotensin system is inactive
ace inhibitors may have limited use
What is the optimal treatment for ESRD
renal transplantation
Why is renal transplantation the optimal Tx
normal renal function is there
no dietary restrictions
normal energy and fertility
Who has priority for renal transplants
children
Are kidneys removed in a transplant
No
new kidney is placed in pelvis
it is vulnerable in contact sports
What are the transplant problems
rejection
immunosuppression
high cardiovascular mortality
osteoporosis risk
Why is there transplant rejection
the immune system treats it as foreign and attacks it
Why is there immunosuppression in transplant
Due to medications taken to stop rejection
reduce the immune system reaction overall
What is a transplant patient who is immunosuppressed at risk of
increased infection risk
malignancy risk
