Dialysis

Question 1

What does AKI stand for

Answer 1

acute kidney injury

Question 2

What is meant by prerenal

Answer 2

Anything that means reduced blood flow/ reduced subtrate for the kidney

Question 3

What is meant by intrinsic renal disease

Answer 3

A disease within the kidney iteself

Question 4

What is post renal disease

Answer 4

Anything after the kidney

Question 5

What is meant by the STOP mneumonic used for finding the cause of aki

Answer 5

S=sepsis and hypoperfusion (pre kidney)
Toxicity= intrinsic
Obstruction= post
Primary= intrinsic

Question 6

In which 5 areas are the abnormalities

Answer 6

Salt
Water
Electrolytes
Acidosis
Toxins

Question 7

How do patients with AKI present

Answer 7

• Acutely unwell

- Hypertensive and oliguric

Question 8

How do patients with AKI’s kidneys appear on imaing

Answer 8

Normal sized

Question 9

How is chronic renal failure different to acute?

Answer 9

As well as abnormalities in SWEAT, hormone abnormalities

Question 10

How do nephrons appear/ act in chronic renal failure

Answer 10

Injured neurons replaced with fibrosis

Normal nephrons gradually fail due to hyperfiltration

Question 11

How does urine differ in chronic renal failure than to a healthy person

Answer 11

Normal urine output as scarring is usually tubular

Urine quality reduced

Question 12

What are the variables of the MDRD equation?

Answer 12

Creatinine concentration
Age
Sex
Race

Question 13

When is renal replacement therapy begun

Answer 13

When symptomatic: GFR 5-10ml

Question 14

What should be the ideal option for patients with chronic kidney disease

Answer 14

Transplatation

Question 15

What are the principles of dialysis

Answer 15

Exchange of solutes and fluids across a membrane (diffusion, convection)

Question 16

What is meant by convection

Answer 16

Either have lower pressure or lower osmotic load on other side of membrane, causing solutes to cross

Question 17

What is peritoneal dialysis

Answer 17

Artificial tube that enters through abdominal wall and travels through a subcutaneous

Question 18

How is infection avoided with peritoneal dialysis

Answer 18

• Longer subcutaneous tract means that bacteria is less likely to travel down
• Cuffs at each end form a seal to prevent movement of bacteria

Question 19

What diffuses across the membrane in peritoneal dialysis

Answer 19

Potassium
Urea
Water
Creatinine
H+ ions

Question 20

What can be used to draw water across the peritoneal membrane

Answer 20

Glucose
Buffers- given to the patient
HC03-/ lactate in high concentration

Question 21

What is done when the concentration gradients even out over time

Answer 21

Drain the fluid

Start ahain

Question 22

What are the complications of peritoneal dialysis

Answer 22

Peritonitis

Loss of membrane function

Question 23

Advantages of peritoneal dialysis

Answer 23

Continuous, indepdence
Less demanding on the heart
Assisted APD

Question 24

Disadvantages of peritoneal dialysis

Answer 24

Depends on patient competence

Membrane eventually fails (most patients only on it 3-5 years)

Question 25

What is the principle of haemodialysis

Answer 25

Blood flows through tubes and fluid/ diasylate flows in opposite direction around the tubes
Solutes diffuse out

Question 26

Pros of haemodialysis

Answer 26

Hospital or home based

Efficient

Question 27

Cons of haemodialysis

Answer 27

Access to circulation

Limited by staff and space

Question 28

Complications of haemodialysis

Answer 28

Access complication: thrombosis, infections, lack of access