Renal Replacement Therapy (Dialysis, transplant etc) Flashcards
How does dialysis work?
Works using the concentration gradients between the dialysis fluid and the blood.
Blood is passed through an artificial membrane or the peritoneum - the size of the pores in the membrane determine what is allowed to enter and leave the blood.
What are the two types of dialysis?
Haemodialysis
Peritoneal dialysis
List the disadvantages of haemodialysis.
Time consuming (up to 8 hours) - blood has to be passed through the machine a few times before the electrolyte balance is restored and the waste is removed.
Can’t be done overnight due to infection risk
What must occur before the patients can undergo haemodialysis?
Anticoagulation of the blood - prevents clotting in the machine.
How does peritoneal dialysis occur?
Fluid is pumped into the peritoneum, left for the electrolyte balance to be restored and for the waste to be removed and then taken back out of the peritoneum.
What are the advantages of peritoneal dialysis?
Can be done everyday.
Can occur overnight or throughout the day - various patterns of use.
Can carry out a normal life whist dialysis is occurring.
Easy to travel with
What is the disadvantage of peritoneal dialysis?
Patient has to take responsibility for their own treatment.
What can dialysis restore?
Excretory function
Acid base balance
Water and electrolyte balance
What can dialysis NOT RESTORE?
Renal endocrine function
Renal endocrine function cannot be restored by dialysis, how are these components restored in a patient with renal failure?
Reduction in erythropoietin production- restored using EPO injections.
Reduction in renin production - hypertension control is necessary via limiting the use of ACE inhibitors.
Reduction in calcium metabolism - vitamin D supplements given to maintain bone mass.
How long will renal transplants last if there are no complications?
Temporary measure as they will only last 10/15 years
What do renal transplants restore?
Renal function
No dietary restrictions
Normal energy and fertility.
What problems are associated with renal transplants?
Rejection; acute or chronic
Immunosuppression: From the medication taken to prevent the immune system from attacking the newly transplanted kidney.
High cardiovascular mortality
Osteoporosis risk - bone mass decreases over time after transplant.
Where is the kidney transplanted to?
Implanted in the pelvis.
New kidney is placed alongside the non-functioning kidneys.
What what you consider in terms of renal replacement therapy and dental treatment?
Those undergoing haemodialysis undergo dental treatment after they have has their dialysis session.
(THIS DOES NOT APPLY TO PERITONEALDIALYSIS)
