Diuretics and Renal Replacement Therapy Flashcards Preview

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Flashcards in Diuretics and Renal Replacement Therapy Deck (65)
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31

Give some symptoms of uraemia

Reduced appetite
Nausea/vomiting
Pruritus

32

Why do lots of drugs require dose alteration with CKD?

Reduced metabolism and/or elimination of the drug
Drug sensitivity can be increased

33

What are the treatment options when the kidneys fail?

Haemodialysis
Peritoneal dialysis
Transplant
Conservative care

34

Describe haemodialysis

Artificial pump in system to keep at high enough pressure
Anti-coagulant added
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

35

How often does haemodialysis have to be performed?

4 hours
3 times a week

36

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

37

Approximately how many tablets per day do people on haemodialysis have to take?

19

38

What are the contraindications for haemodialysis?

Failed vascular access
Heart failure
Coagulopathy

39

What are some complications of haemodialysis?

Lines: infection, thrombosis, venous stenosis
Thrombosis, bleeding, access failure - steal syndrome
CVS instability
Feel chronically unwell
Accumulate morbidities

40

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

41

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

42

Approximately how many medications does a patient on peritoneal dialysis have to take per day?

10 tablets
SC EPO injection

43

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

44

How often do patients on peritoneal dialysis get peritonitis?

Once every 20 months on average

45

Give some complications of peritoneal dialysis

Peritonitis
Ultrafiltration failure
Leaks
Development of hernia

46

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

47

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

48

Does a transplant have a higher or lower mortality/morbidity than dialysis?

Lower
Better quality of life too

49

For how long is the peri-operative risk after transplant?

3 months

50

What are the peri-operative risks of kidney transplant?

Dampening of immune system:
Malignancy
Infection
Risk of diabetes and hypertension from meds (steroids)

51

What vessels do they connect renal transplants to?

Iliac vessels

52

What are the different types of transplant?

Live donor (related or unrelated)
Deceased after brain death (DBD)
Deceased after circulatory death (DCD)

53

Kidney transplants are matched according to ...

Tissue match - blood type and HLA
Length of time on waiting list
Age

54

What is the average wait for a kidney from a deceased donor?

3 years

55

What is the average life of the transplanted kidney from a live related donor?

12 years

56

What is the average life of the transplanted kidney from a live unrelated donor?

11 years

57

What is the average life of a transplanted kidney form a DBD donor?

10 years

58

How many immunosuppressants are you generally on after a kidney transplant?

3

59

What are the problems with being on immunosuppressants after a kidney transplant?

LOTS of side effects
Including being nephrotoxic

60

Dialysis tends to prolong survival by how long?

2 years