5.1.2 e kidney failure

Question 1

what will happen to the kidneys if they are infected or affected by high blood pressure?

Answer 1

protein in the urine
blood in the urine

Question 2

what does protein in urine show?

Answer 2

basement membrane or podocytes of the Bowman’s capsule are damaged so they no longer act as filters
large plasma proteins can pass into filtrate and then urine

Question 3

what does blood in urine mean?

Answer 3

filtering process is no longer working

Question 4

what happens if the kidneys fail completely?

Answer 4

loss of electrolyte balance
build-up of toxic urea in the blood
high blood pressure
weakened bones
pain and stiffness in joints
anaemia

Question 5

why does kidney failure cause loss of electrolyte balance?

Answer 5

body cannot excrete excess sodium, potassium and chloride ions
causes osmotic imbalances in the tissues and eventual death

Question 6

why does kidney failure cause build-up of toxic urea?

Answer 6

body cannot get rid of urea and it poisons cells

Question 7

why does kidney failure cause high blood pressure?

Answer 7

blood pressure increases which causes a range of health problems including heart problems and stroke

Question 8

why does kidney failure cause weakened bones?

Answer 8

calcium/ phosphorus balance in the blood is lost

Question 9

why does kidney failure cause pain and stiffness in joints?

Answer 9

abnormal proteins build up in the blood

Question 10

why does kidney failure cause anaemia?

Answer 10

kidneys are involved in the production of a hormone called erythropoietin that stimulates the formation of red blood cells
when the kidneys fail it can reduce the production of red blood cells causing tiredness and lethargy

Question 11

what is used as a measure to indicate kidney disease?

Answer 11

glomerular filtration rate

Question 12

how is the rate of filtration measured?

Answer 12

blood test to measure the level of creatinine in the blood

Question 13

what is creatinine?

Answer 13

a breakdown product of muscles

Question 14

what does it show if the levels of creatinine in the blood goes up?

Answer 14

signal that kidneys are not working properly

Question 15

normal GFRs don’t fall below…

Answer 15

70

Question 16

what does a GFR of below 60 for more than three months indicate?

Answer 16

moderate to severe chronic kidney disease

Question 17

what is the GFR for kidney failure?

Answer 17

below 15

Question 18

what are the two main types of dialysis?

Answer 18

haemodialysis
peritoneal dialysis

Question 19

what are the two ways kidney failure is treated?

Answer 19

renal dialysis
transplant

Question 20

where is haemodialysis usually carried out?

Answer 20

hospital

Question 21

how does haemodialysis work?

Answer 21

blood leaves the patient’s body from an artery and flows into the dialysis machine where it flows between partially permeable membranes

Question 22

what do the partially permeable membranes in haemodialysis mimic?

Answer 22

the basement membrane of the Bowman’s capsule

Question 23

what is on the other side of the membrane in haemodialysis?

Answer 23

dialysis fluid

Question 24

what needs to happen during haemodialysis?

Answer 24

patients lose excess urea and mineral ions that have built up in the blood

Question 25

what can’t happen in haemodialysis?

Answer 25

lose useful substances like glucose and some mineral ions

Question 26

how do you stop useful substances from leaving during haemodialysis?

Answer 26

careful control of the dialysis fluid

Question 27

what does dialysis fluid contain for haemodialysis?

Answer 27

normal plasma levels of glucose normal plasma levels of mineral ions

Question 28

why does dialysis fluid contain normal levels of glucose?

Answer 28

no net movement of glucose occurs out of the blood

Question 29

why does dialysis fluid contain normal levels of mineral ions?

Answer 29

any excess mineral ions in the blood move out by diffusion down a concentration gradient into the dialysis fluid which restores the correct electrolyte balance of the blood

Question 30

what does the dialysis fluid not contain for haemodialysis?

Answer 30

urea

Question 31

why does dialysis fluid not contain urea?

Answer 31

very steep concentration gradient from blood to the fluid so as much urea is removed as possible

Question 32

why does the blood and the dialysis fluid flow in opposite directions?

Answer 32

maintain a countercurrent exchange system maximise exchange that takes place

Question 33

what does the whole process of dialysis depend on?

Answer 33

diffusion down concentration gradients

Question 34

how often does dialysis need to be repeated?

Answer 34

several times a week for many hours

Question 35

along with haemodialysis, what else do patients with kidney failure have to do?

Answer 35

manage their diets carefully eat little protein and salt monitor fluid intake to keep blood chemistry stable

Question 36

when is the only time haemodialysis patients can eat whatever they want?

Answer 36

beginning of dialysis process

Question 37

what does peritoneal dialysis use?

Answer 37

natural membranes formed by the lining of the abdomen (peritoneum)

Question 38

where is peritoneal dialysis usually done?

Answer 38

at home patient can carry on with normal life while doing it

Question 39

how does dialysis fluid enter the body?

Answer 39

using a catheter

Question 40

what happens in the process of peritoneal dialysis?

Answer 40

dialysis fluid is left for several hours so that urea and excess mineral ions pass out the blood capillaries into the tissue fluid and out across the peritoneal membrane into the dialysis fluid

Question 41

what happens to the dialysis fluid after peritoneal dialysis?

Answer 41

drained off and discarded leaving the blood balanced again and the urea and excess minerals removed

Question 42

what is the best solution for a patient with kidney failure?

Answer 42

kidney transplant

Question 43

how is a new kidney transplanted?

Answer 43

blood vessels and the ureter of the new kidney is inserted into the bladder

Question 44

what is the main problem with a transplanted kidney?

Answer 44

risk of rejection as antigens on the donor organ are different from the antigens on the cells of the patient immune system is likely to recognise this

Question 45

how do you reduce the risk of rejection with a transplanted kidney?

Answer 45

match between antigens of the donor and the recipient is made as close as possible patient is given immunosuppressant drugs for the rest of their lives

Question 46

what do immunosuppressant drugs do?

Answer 46

suppresses immune system which helps to prevent rejection of the new organ

Question 47

what is the disadvantage of immunosuppressant drugs?

Answer 47

prevents patients from responding effectively to infectious diseases so they have to take great care if they become ill

Question 48

how long does an average transplanted kidney last for?

Answer 48

9-10 years