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Flashcards in Urinary: Renal Support Deck (18):
1

What is the definition of end stage renal failure?

When death is likely without renal replacement therapy
eGFR <15ml/min

2

What are the psychological symptoms of end stage renal disease?

Tiredness: overwhelming fatigue, physically and mentally exhausted, feel guilty for needing to rest
Difficulty sleeping and concentration
?symptoms dont differ much from depression

3

What are the physical symptoms of end stage renal disease?

- volume overload eg oedema
- nausea and vomiting
- restless legs
- pruritus (intense itching)
- sexual dysfunction
- increased infections

4

How does chronic kidney disease affect water and salt handling by the kidney?

There is reduced GFR so lose the ability to maximally dilute and concentrate urine

5

What symptoms does accumulation of waste products cause?

Reduced appetitie - particularly meat which may be a protective mechanism to prevent nitrogenous waste products
Nausea and vomiting
Contributes to pruritus

6

Why do you need to alter drug doses in someone with CKD/ESRD?

There is reduced metabolisms and/or elimination
Drug sensitivity can be increased making side effects more likely eg statins

7

What is the endocrine function of the kidney?

Synthesises renin for the RAAS system
Vitamin D metabolism
Synthesis erythropoietin needed for RBC production

8

What are the pros and cons of unit-based haemodialysis?

4hrs 3x per week
Advantages: less responsibility, have days off
Disadvantages: travel time, have a set slot which need to stick to, big restriction on fluid and food intake

9

Who is not suitable for haemodialysis?

- if there is no vascular access
- if they have bad heart failure (have to take 300ml blood out at a time)
- if they have coagulopathy (a vein has to be attached to artery so is high pressure and can bleed lots)

10

What are some potential complications of haemodialysis?

Lines - infection, thrombosis, scarring
CVS instability
Feel chronically unwell

11

What are the 2 types of peritoneal dialysis?

CAPD: 4-5 bags throughout the day
APD: overnight dialysis, connect to a machine

12

What are the pros and cons of peritoneal dialysis?

Advantages: more independence, less food and fluid restrictions, can travel, better renal preservation initially
Disadvantages: there needs to be frequent 30 min exchanges, you have responsibility for your own care

13

Who is not suitable for peritoneal dialysis?

- if they are obese or have large muscle mass, poor peritoneal area to whole body ratio
- failure of peritoneal membrane eg too much scarring from previous surgery
- hernias, stomas

14

What are some potential complications of peritoneal dialysis?

- peritonitis (average of 1 episode every 20 months)
- tunnel site infections
- leaks
- development of herniae

15

What are the pros and cons of renal transplant?

Advantages: reduced mortality and morbidity compared to dialysis, better quality of life
Disadvantages: operative risk, malignancy risk, infection, have to take immunosuppressants

16

What are the different types of transplant?

Live donor
Deceased after brain death - so organs still perfused
Deceased after circulatory death - so organs not perfused

17

How long does a transplant last?

around 11 years

18

What is conservative life care?

For those who dont want to have dialysis eg the elderly

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