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1

Dialysis

filtering metabolic waste products from blood; separation of dissolved substances from a solution by allowing the solution to diffuse through a semipermeable membrane

2

Hemodialysis

Removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure

3

Peritoneal Dialysis (PD)

a Tx for patients with severe chronic kidney disease; uses patient's peritoneum as a membrane across which fluids and dissolved substances are exchanged

4

What substances are exchanged with peritoneal dialysis?

Electrolytes, urea, glucose, albumin and other small molcules

5

Continuous Ambulatory Peritoneal Dialysis (CAPD)

Fluid is introduced through a tube in the abdomen and flushed out either every night while the patient sleeps or via regular exchanges throughout the day

6

What is used as an alternative to hemodialysis, especially in kids?

Peritoneal dialysis (PD)

7

Dialysate solution

dialysis solution in the dialyzer helps remove wastes/fluid from blood.

8

Dialyzer

artificial kidney filter designed to provide controllable transfer of solutes and water across a semi-permeable membrane separating flowing blood and dialysate streams

9

What does a dialysate solution contain?

Chemicals in concentrations similar to blood, a mixture of purified water and measured chemicals, which flows countercurrent on the outside.

10

What substances that must remain in the blood stream?

Glucose sodium calcium magnesium

11

Substances that must remain the in blood stream are in what concentrations in the dialysate solution?

Concentrations similar to blood

12

What does the composition of dialysate determine?

Which solutes pass out of and which stay in teh blood during dialysis

13

What transfer processes occur in a dialyzer?

Diffusion (dialysis) and convection (ultrafiltration)

14

What are the three basic dialyzer designs?

Coil, parallel plate, hollow fiber configurations

15

What is one of the major modes of mass transfer?

Convection (diffusion is another; diffusive transport)

16

What type of kidney failure do we create on bypass?

Acute renal failure

17

Acute renal failure (ARF)

A sudden loss of kidney function caused by an illness, an injury, or a toxin that stresses the kidneys (kidney function may recover)

18

Chronic Kidney Disease (CKD)

A long and usually slow process where the kidneys lose their ability to function

19

Why type of kidney failure will you get with stenosis in the renal artery?

CKD

20

End-stage renal disease (ESRD)

When the kidneys have completely and permanently shut down

21

Would we give mannitol for ESRD?

no because it's cleared in the kidneys

22

Renal failure defintiion

decrease in GFR

23

How is renal failure detected biochemically?

Elevated serum creatinine level

24

How do we characterize ARF?

1. Rapid loss of kidney function (hypovolemia)
2. Causes include low blood volume
3. Exposure to harmful substances
4. Obstruction of urinary tract

25

What lab findings help us diagnose acute kidney injury?

Elevated blood urea nitrogen level (BUN)
Elevated creatinine
Inability of the kidneys to produce sufficient amounts of urine

26

What are some complications of ARF?

Metabolic acidosis
High K+ levels
Uremia
Changes in body fluid balance (big shift)
Effects to other organ systems

27

How is chronic kidney disease identified?

Significantly elevated creatinine

28

What do higher levels of creatinine indicate?

Falling GFR; and as a result decreased capability of the kidneys to excrete waste products

29

What are creatinine levels in early stages of chronic kidney disease?

may be normal

30

Problems frequently encountered in kidney malfunction

-Abnormal fluid levels in body
-deranged acid levels
-Abnormal potassium, calcium, phosphate
-anemia
-hematuria (blood loss in urine)
-proteinuria (protein loss in urine)