L15: Dialysis And Transplantation

Question 1

How many stages of chronic kidney disease is there

Answer 1

5

Question 2

Which stage of chronic kidney disease is the worst

Answer 2

Stage 5

Question 3

In stage 5 chronic kidney disease what is the patient not able to maintain

Answer 3

Water homeostasis
Electrolyte balance
Acid base
Excrete metabolic waste

Question 4

What are the 3 main ways to replace kidney function

Answer 4

Dialysis
Transplantation
Palliative care

Question 5

What are the 2 types of dialysis

Answer 5

Heamodialysis

Peritoneal

Question 6

Which function of the kidney does dialysis not replace

Answer 6

Hormone production such as vitamin d and EPO for RBC production in the bone marrow

Question 7

Does transplantation replace all the functions fo the kidney including the hormone production

Answer 7

Yes

Question 8

What barrier is used to separate the blood and the dialysis fluid during dialysis

Answer 8

A semi permeable membrane

Question 9

What are the 3 processes that the dialysis relies on for movement of substances across the semi permeable membrane

Answer 9

Diffusion
Osmosis
Mass transport

Question 10

What is the semi permeable membrane that we use in haemodialysis

Answer 10

Haemodialysis membrane which is an artificial membrane in the tube

Question 11

What is the semi permeable membrane that we use in peritoneal dialysis

Answer 11

Peritoneum

Question 12

What is the peritoneum

Answer 12

Lining of the abdominal cavity

Question 13

What happens to the substances when the kidney does not work

Answer 13

Accumulation if
Water
Sodium 
Urea
Potassium 
Acidosis as you use of hco3-

Question 14

What is inside the dialysis fluid

Answer 14

Water
Dectosal glucose
A bit of : sodium, potassium
Bicarbonate so it enters the blood and restores the ph

Question 15

What sets the osmotic pressure to draw water to it inside the dialysis fluid

Answer 15

Decta glucose

Question 16

Describe the movement of substances from the peritoneum to the dialysis fluid

Answer 16

Water flows down to dilute the glucose
Sodium, potassium and urea flow down concentration gradient via diffusion
Bicarbonate moves into the circulation

Question 17

Where can patients use peritoneal dialysis

Answer 17

At home

Question 18

Is the peritoneal dialysis permanent

Answer 18

Yes

Question 19

How many years does the peritoneal dialysis work until the peritoneum wears out

Answer 19

10 years

Question 20

What are the risk factors of peritoneal dialysis

Answer 20

Infection to the peritoneum e.g peritonitis

Question 21

Describe how hemodialysis works

Answer 21

Takes blood out of the body then gives blood back to the patient through the vessels

Question 22

Where can the patient carry out haemodialysis

Answer 22

In hospital

Question 23

How many times a week does the patient have to attend to the hospital for hemodialysis

Answer 23

3 times a week for 4 hours

Question 24

How do we restore ph using a dialysis

Answer 24

Give bicarbonate to the patient through the dialysate fluid

Question 25

Who is peritoneal dialysis better for

Answer 25

Patient with Severe heart disease | Young patients

Question 26

When do we start a patient on dialysis

Answer 26

Chronic kidney disease | Acute kidney injury

Question 27

What are the problems with dialysis

Answer 27

``` Risk of infection Cardiac disease Anaemia Bone disease Malnutrition ```

Question 28

In transplantation does the old kidney get taken out

Answer 28

No unless there is a reason to such as cancer

Question 29

Where do we place the new kidney in transplantation

Answer 29

Iliac fossa

Question 30

Which vessels to we join the kidney to

Answer 30

Iliac vessels

Question 31

Who should have a transplant

Answer 31

Patients with stage 5 chronic kidney disease | People who are fit for surgery

Question 32

Which patients should not have transplantation

Answer 32

Patients with: Cardiac disease Recurrent disease Non compliance

Question 33

What do we mean by recurrent disease

Answer 33

A disease that can appear onto the kidney again

Question 34

What do we mean by patients who are non complaint

Answer 34

Patients who agree to do the treatment but do not do it

Question 35

Where are kidneys in transplantation form

Answer 35

Patient donors: cardiac or cerebral death | Alive donors: friends and family, random person

Question 36

How do we avoid rejection after a kidney transplant

Answer 36

``` Match: ABO blood group Match HLA Screen for donor antibodies Drugs such as immunosuppressants ```