Unit 3 Extras - Dialysis & Diuretics

What is the average percentage of body water in adults

About 60% by mass

How are electrolyte and fluid balance managed in the body

Through intake and output

What do diuretics do

They increase fluid output

What are the three fluid compartments in the body

Intravascular, intracellular, and interstitial

Name five conditions that require diuresis

1. Congestive Heart Failure

2. Hypertension

3. Ascites (fluid in abdomen)

4. Peripheral Edema (swelling in limbs)

5. Pulmonary Edema (swelling in lungs)

What are the six main classifications of diuretics

1. Carbonic Anhydrase Inhibitors

2. SGLT2 Inhibitors

3. Loop Diuretics

4. Thiazide Diuretics

5. Potassium-Sparing Diuretics

6. Miscellaneous

What is an example of a carbonic anhydrase inhibitor

Acetazolamide

What part of the nephron do carbonic anhydrase inhibitors act on

Proximal convoluted tube

Give an example of an SGLT2 inhibitor

Canagliflozin

What part of the nephron do SGLT2 inhibitors act on

Proximal convoluted tube

Name an example of loop diuretics

Furosemide

What is the most potent type of diuretics

Loop

What part of the nephron do loop diuretics act on

Nephron loop

Name an example of thiazide diuretics

Hydrochlorothiazide

What part of the nephron do thiazide diuretics act on

Distal convoluted tube

What is the best diuretic for hypertension

Thiazide

Name an example of a potassium-sparing diuretic

Spironolactone 

What part of the nephron do potassium-sparing diuretics act on

Distal convoluted tube

What are some adverse effects of diuretics

Dehydration, Thirst, Hypovolemia, Hypotension, Dizziness, Syncope, Urinary frequency

What does GFR measure 

The rate at which kidneys filter blood

What is a normal GFR value

>90 mL/min

What affects GFR

Blood flow to the kidneys

What does a reduced GFR indicate

Kidney disease

What is Chronic kidney disease (CKD)

Long-term kidney damage resulting in reduced GFR

What are the main risk factors for CKD

Diabetes and hypertension (they damage glomerular vessels)

How is CKD staged

• Mild: <90 mL/min

• Moderate: <60 mL/min

• Severe: <30 mL/min

What GFR value indicates kidney failure 

<15 mL/min

What are the signs of kidney failure

Inadequate waste removal, electrolyte disturbances, reduced urine output, and the need for dialysis or transplant

How does dialysis work

Blood exits the body, is filtered by a machine, and returned

What is the function of the dialysis machine

Performs the filtration functions of kidneys

What access is required for dialysis

Arteriovenous fistula

What is a kidney transplant

Addition of a donor kidney (usually on the right side); failing kidneys are left in place

What does a kidney transplant require

Lifelong immunosuppressive therapy and monitoring

How many working kidneys are needed to live off dialysis

Only one