Treating kidney failure Flashcards
1
Q
Where is haemodialysis done?
A
- dialysis machine
- usually in hospital
2
Q
How does haemodialysis work?
A
- blood leaves patient from an artery
- flows into dialysis machine - between partially permeable dialysis membrane
- these mimic the basement membrane of the Bowman’s capsule
3
Q
What is in the dialysis fluid?
A
- it contains normal plasma levels of glucose to ensure there is no net movement out the blood
- normal mineral ions - any excess move out the blood down a diffusion gradient - restores electrolyte balance
- no urea - very steep concentration - lots leaves
4
Q
Which direction does the dialysis fluid travel in?
A
- opposite direction to the blood
- maintains a countercurrent exchange system
- this maximises the exchange that takes place
5
Q
WHat is the problem with haemodialysis?
A
- takes about 8 hours
- has to be repeated regularyl
- several times a week
- need to manage diet
- low levels of protein, salt
- monitoring fluid intake to keep their blood chemistry as stable as possible
- the only time they can eat and drink what they like is at the beginning of the dialysis process
6
Q
What is periotneal dialysis?
A
- done inside the body
- makes use of the natural dialysis membranes formed by the lining of the abdomen
- that is the peritoneum
7
Q
Where is peritoneal dialysis done?
A
- at home
- patient can carry on with normal life
8
Q
What is the process of peritoneal dialysis?
A
- enter the abdomen using the catheter
- left for several hours for dialysis to take place
- urea and excess mineral ions enter the surrounding tissue fluid and across the peritoneal membrane
- fluid is then drained off and discareded
- leaves the blood balanced again and the urea and excess mineral removed
9
Q
Why may transplant need to be done?
A
long-term dialysis has some serious side effects
10
Q
How is transplant done?
A
healthy kidney enters the body
blood vessels are joined
ureter of the new kidney is inserted in the bladder
if done properly, will function as normal for many years
11
Q
What is the main problem with transplant?
A
- risk of rejection
- antigens on the donor organ differ from the antigens on the cells of the recipient and the immune system is likely to recognise this
- this can result in rejection and the destruction of the new kidney
- only last 10 years
12
Q
How is risk of rejection reduced?
A
- match between the antigens of the donor and the recipient is made as close as possible
- recipient is given drugs to supress their immune system for the rest of their lives
13
Q
What is the problem with taking immunosuppresant?
A
- prevent the patients from responding effectively to infectious diseases
- they have to take care
- on
14
Q
WHy dialysis or transplant?
A
- more readily available
- shortage of donor kidneys
- cars are safer - fewer road traffic deaths
- patient can lead relatively normal life
15
Q
Why transplant over dialusis?
A
- no need to spend hours attached to a machine
- no need to regulate diet
- long-term dialysis is more expensive than trasnplant
- dialysis damages the body
- free from retrictions
