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BDS2 BAMS > Renal 2 replacement therapy > Flashcards

Renal 2 replacement therapy Flashcards

1
Q

What are examples of renal functions? (4 points)

A
  • Excretory function
  • Water and electrolyte balance
  • Acid base balance
  • Renal endocrine function (erythropoietin, calcium metabolism, renin secretion)
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2
Q

Is renal dialysis an active or passive process?

A

PASSIVE process:

  • Diffusion across concentration gradie nts
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3
Q

What is the purpose of dialysis?

A

Allows intermittent correction of changes in plasma concentration of small molecules

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4
Q

Is dialysis a renal replacement?

A
  • No, not true replacement

- Significant lifestyle restrictions remain

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5
Q

What are the 2 types of renal dialysis?

A
  • Haemodialysis

- Peritoneal dialysis

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6
Q

Where does haemodialysis occur?

A
  • Outside the body
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7
Q

Where does peritoneal dialysis occur?

A
  • Inside the body
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8
Q

How does the membrane in dialysis determine what can enter and leave the blood? (6 points)

A
  • Membrane is like a bit of clingfilm with tiny holes in it
  • Depending on the size of the holes in membrane can determine what gets through
  • Can design membrane to allow electrolyte, protein and cell exchange
  • Design solution on one side to be what you want to achieve on the other side
  • Want to make a concentration gradient
  • E.g. if want high Na+ in blood but have low content in blood then put high content in the fluid so will diffuse due to the concentration gradient
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9
Q

When using haemodialysis, why do we need to give the patient heparin?

A
  • To stop the blood from clotting (anticoagulant)
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10
Q

What is a potential problem with peritoneal dialysis?

A

If get an infection of the peritoneum you have a serious problem

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11
Q

What are the advantages of peritoneal dialysis? (5 points)

A
  • Can do this day and night
  • Could put some in in the morning and take it out in the evening
  • Could do only at night and cycle it quickly at night
  • Because you can do it at home you can do it everyday
  • If on peritoneal dialysis then can take your machine with you on holiday and all you need to get is the solution when you arrive at the destination
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12
Q

What is a disadvantage of peritoneal dialysis?

A
  • Some patient’s don’t like the responsibility of being in charge of it (would rather go to the hospital to get it done)
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13
Q

What renal functions will dialysis restore? (3 points)

A
  • Excretory function
  • Water and electrolyte balance
  • Acid base balance
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14
Q

How is erythropoietin replaced?

A
  • By EPO injections

- Maintains red cell mass

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15
Q

How is bone mass function maintained? (2 points)

A
  • Vit D supplementation

- Osteoporosis prevention programme

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16
Q

How can hypertension be controlled?

A

The renin-angiotensin system is inactive so ACE inhibitors may have limited use

17
Q

What is the optimal treatment for end stage renal disease?

A

A transplant

18
Q

Does a renal transplant give normal renal function?

A

Yes

19
Q

Does a renal transplant give the patient any dietary restirctions?

A

no

20
Q

Does a renal transplant give normal energy and fertility?

A

Yes

21
Q

A renal transplant is a temporary fix, how long is it likely to last?

A
  • 10-15 years
22
Q

Why do you not need to remove the old kidneys when carrying out a renal transplant?

A

As the new kidney is placed in the pelvis as it is easier to place it there - easy to plumb into artery, vein, bladder

  • However, this kidney is vulnerable to damage
23
Q

What are possible problems with a renal transplant? (4 points)

A
  • Rejection (acute or chronic)
  • Immunosuppression (increased infection/malignancy risk)
  • Higher CV mortality
  • Osteoporosis risk
24
Q

Is a renal transplant likely to last for longer is the donor is alive or dead?

A

Alive

25
Q

When should you treat a patient with renal failure?

A

AFTER they have had their haemodialysis session

26
Q

What should you do about drugs and people with renal failure?

A

Liase with their physicians

27
Q

What are 4 drugs that a person with renal failure could be on that may interact or cause complications in dentistry?

A
  • Prednisolone
  • Azathioprine
  • Tacrolimus
  • Cyclosporin
28
Q

Does renal treatment increase oral cancer risk?

A
  • Yes, be suspicious of oral mucosal lesions

BDS2 BAMS (57 decks)

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