Renal Replacement Therapy - Dialysis and Transplants

These flashcards cover key concepts, definitions, and important factors related to renal replacement therapy, including dialysis and kidney transplantation.

Renal replacement therapy

A treatment method for patients with kidney failure that includes dialysis and transplantation.

Dialysis aims

To remove excess fluid and solutes, extend life, and be compatible with quality of life.

Counter current flow

A mechanism in dialysis that helps maintain a diffusion gradient.

Dialyser

A device used in dialysis where blood and dialysate flow in opposite directions.

Typical haemodialysate solution

Contains sodium, potassium, calcium, magnesium, chloride, bicarbonate, and glucose.

Fluid removal by dialysis

Occurs through a hydrostatic pressure gradient created by the dialysis machine.

Diffusion

The process of solute clearance where molecules move down their concentration gradient.

Convection

The movement of solute with fluid across the dialysis membrane, effective for larger molecules.

Factors affecting diffusion rate

Include concentration gradient, molecular size, solute charge, membrane surface area, and blood flow rate.

High flux dialysers

Dialysers that are more effective at removing larger molecules.

Transmembrane pressure

The pressure gradient that affects ultrafiltration in dialysis.

Patient factors influencing dialysis

Include residual renal function, dietary intake, and adherence to medications.

Peritoneal dialysis

A mode of renal replacement therapy using the patient's peritoneum for fluid exchange.

Complications of peritoneal dialysis

Include infections, catheter malposition, hernias, leaks, and constipation.

Successful haemodialysis requirements

Include time spent, vascular access, patient adherence, and dietary restrictions.

Arterio-venous fistula

A surgical connection between an artery and a vein for blood access in haemodialysis.

Complications of vascular access

Include infection and vascular issues such as stenosis and thrombosis.

Tertiary hyperparathyroidism

Excessive secretion of parathyroid hormone due to chronic kidney disease.

Donation organs types

Include living and cadaveric (deceased) donors.

Brain stem death criteria

Rigorous tests confirming irreversibility of brain function for organ donation.

Ischaemic time in transplantation

Refers to the duration the organ is not perfused, affecting viability.

Calcineurin inhibitors

A class of drugs used to prevent organ rejection in transplantation.

Risks of transplantation

Include infections, malignancies, and individual drug side effects.

Healthy patient haemodialysis schedule

Typically 4 hours, three times a week.

Immunological barriers in transplantation

Refer to the genetic differences between donor and recipient leading to immune responses.

HLA

Human Leukocyte Antigen, involved in immune responses to transplanted organs.

Types of transplant rejection

Include hyperacute, acute, and chronic rejection.

Paired donation

A process where incompatible donor-recipient pairs can swap donors.

Preformed antibodies

Antibodies present before transplantation that can lead to rejection.

Accommodation in transplantation

Normal graft function despite the presence of anti-donor antibodies.

Tolerance in transplantation

A state of indefinite graft survival without immunosuppression.

Future of transplantation

Includes possibilities like cell-based therapy and regulatory cell infusion.

Cyclosporin

An immunosuppressant that made organ transplantations feasible in the 1970s.

Ultra-filtration

The process of removing excess fluid from the blood during dialysis.

Quality of life in dialysis patients

Often hampered by fluid and dietary restrictions and medication adherence.