Flashcards in Diuretics and Renal Replacement Therapy Deck (65)
Give some symptoms of uraemia
Why do lots of drugs require dose alteration with CKD?
Reduced metabolism and/or elimination of the drug
Drug sensitivity can be increased
What are the treatment options when the kidneys fail?
Artificial pump in system to keep at high enough pressure
Gets rid of waste products in blood over artificial membrane
Enters back into venous system
A fistula has to be created between an artery and vein
How often does haemodialysis have to be performed?
3 times a week
What are the advantages and disadvantages of haemodialysis?
Advantages: less responsibility, days off treatment
Disadvantages: travel to hospital/waiting, 'tied' to your dialysis time, restrictor on travel, restrictions on fluid and food intake
Approximately how many tablets per day do people on haemodialysis have to take?
What are the contraindications for haemodialysis?
Failed vascular access
What are some complications of haemodialysis?
Lines: infection, thrombosis, venous stenosis
Thrombosis, bleeding, access failure - steal syndrome
Feel chronically unwell
Describe peritoneal dialysis
Waste products cross semi-permeable peritoneal membrane into the peritoneal cavity
Can do 4-5 bags throughout the day (30 min each)
Or can do overnight
What are the advantages and disadvantages to peritoneal dialysis?
Advantages: independence, less fluid/food restrictions, fairly easy to travel, renal function may be better preserved
Disadvantages: frequent daily exchanges, responsibility of own care
Approximately how many medications does a patient on peritoneal dialysis have to take per day?
SC EPO injection
What are the contraindications for peritoneal dialysis?
Failure of peritoneal membrane
Adhesions, previous abdo surgery, hernia, stoma
Patient or carer unable to connect/disconnect themselves
Obese/large muscle mass
How often do patients on peritoneal dialysis get peritonitis?
Once every 20 months on average
Give some complications of peritoneal dialysis
Development of hernia
Describe home/nocturnal haemodialysis
Same as haemodialysis but at home and possibly overnight
Allows more dialysis hours so better clearance
Requires someone at home with you - as if it goes wrong you can bleed out v rapidly
What are the advantages of home haemodialysis?
Patient often feels better
Patient often needs fewer medications
Can pick your own schedule
Can do it overnight so doesn't interfere
Does a transplant have a higher or lower mortality/morbidity than dialysis?
Better quality of life too
For how long is the peri-operative risk after transplant?
What are the peri-operative risks of kidney transplant?
Dampening of immune system:
Risk of diabetes and hypertension from meds (steroids)
What vessels do they connect renal transplants to?
What are the different types of transplant?
Live donor (related or unrelated)
Deceased after brain death (DBD)
Deceased after circulatory death (DCD)
Kidney transplants are matched according to ...
Tissue match - blood type and HLA
Length of time on waiting list
What is the average wait for a kidney from a deceased donor?
What is the average life of the transplanted kidney from a live related donor?
What is the average life of the transplanted kidney from a live unrelated donor?
What is the average life of a transplanted kidney form a DBD donor?
How many immunosuppressants are you generally on after a kidney transplant?
What are the problems with being on immunosuppressants after a kidney transplant?
LOTS of side effects
Including being nephrotoxic