Renal Health and Transplant Management Flashcards

A comprehensive set of vocabulary flashcards covering renal physiology, transplant pharmacology, and the management of AKI and CKD.

Special Authority

A funding requirement for high-cost medications such as tacrolimus and sirolimus in New Zealand.

Triple or Quadruple Therapy

The standard of care for immunosuppression using a combination of drugs to target multiple immune mechanisms simultaneously.

Synergy

The strategic targeting of multiple immune pathways (e.g., T-cell activation and proliferation) to more effectively prevent organ rejection than a single agent.

Calcineurin Inhibitors (CNIs)

Considered the pillar of maintenance therapy in transplant patients; includes medications like tacrolimus and ciclosporin.

Induction Agents

Powerful antibodies, such as basiliximab or rabbit-thymoglobulin, administered at the time of surgery to protect the graft during the highest risk period.

PJP Prophylaxis

The administration of co-trimoxazole for 6 months post-transplant to prevent Pneumocystis jirovecii pneumonia.

Valganciclovir

A medication used for 90 days post-transplant to prevent Cytomegalovirus (CMV).

Teach back method

A communication technique where a pharmacist asks a patient to explain medication instructions in their own words to confirm understanding.

End-Stage Renal Disease (ESRD)

Established kidney failure defined as Stage 5 CKD with an estimated Glomerular Filtration Rate (eGFR) of < $15\,mL/min$.

Peritoneal Dialysis (PD)

A renal replacement therapy that uses the lining of the abdomen as a filter for a sterile dialysate solution.

Tissue Typing

A matching process that measures Human Leukocyte Antigens (HLA) to help the immune system distinguish self from foreign tissue.

Lymphocyte Cross-matching

A test used to detect if a transplant recipient has preformed antibodies against the donor's lymphocytes; a positive result is a contraindication for transplant.

Alloimmunity

An immune response where the recipient's T-cells recognize and reject the transplanted organ (allograft).

Nephron

The functional unit of the kidney, with approximately one million present in each organ.

Glomerular Filtration Rate (GFR)

The volume of blood filtered by the glomerular capillaries into the Bowman’s capsule per unit of time ($90-120\,mL/min/1.73m^2$ is considered normal for young adults).

Cockcroft and Gault Equation

$ClCr (mL/min) = \frac{(140 - age) \times body weight (kg) \times factor}{Serum Creatinine (\mu mol/L)}$, where the factor is 1.23 for males and 1.04 for females.

$\beta$-Cyclodextrins

Modified starches used to improve drug solubility that can form insoluble complexes with cholesterol, disrupting renal function; oral intake is restricted to $5\,mg/kg$ body weight.

Self-Microemulsifying Drug Delivery System (SMEDDS)

The technology used in Neoral® to form a homogenous microemulsion in gastric fluids, leading to more predictable absorption of ciclosporine.

PEGylation

The modification of a drug, such as Mircera, with polyethylene glycol to extend its circulating half-life and reduce dosing frequency.

Calcium Resonium

An ion exchange resin (sodium polystyrene sulfonate) used to treat hyperkalaemia by removing potassium from the gastrointestinal tract.

Benephit System

A catheter-based medical device used for Targeted Renal Therapy to deliver drugs directly into the renal arteries.

SGLT2 inhibitors

A pillar of treatment for diabetic nephropathy (e.g., empagliflozin) that blocks sodium and glucose reabsorption to reduce hyperfiltration.

CKD-Mineral Bone Disorder (CKD-MBD)

A systemic complication of CKD resulting in secondary hyperparathyroidism and vascular calcification due to disrupted calcium, phosphate, and Vitamin D levels.

Pre-renal AKI

Acute Kidney Injury caused by reduced blood flow to the kidney from triggers like hypovolaemia, sepsis, or heart failure.

Intrinsic/Intra-renal AKI

Acute Kidney Injury resulting from direct damage to kidney tissue, most commonly caused by Acute Tubular Necrosis (ATN).

Post-renal AKI

Acute Kidney Injury caused by an obstruction to urine outflow, such as kidney stones or benign prostatic hypertrophy.

Calcium Gluconate IV

A treatment used in hyperkalaemia to protect the heart by raising the myocardial threshold potential.