Kidney Failure

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  • Kidney Failure
    • Causes
      • Kidney Infections: The Structure of the podocytes and tubules may be damaged
      • Raised Blood Pressure: can cause damage to the epithelial cells and basement membrane of the Bowmans capsule
        • Can cause protein in the urine- the podocytes and basement membrane no longer act as filters
        • Can cause blood in the urine- shows that the filtering process is not working
      • Genetic Conditions: e.g. polycstic kidney disease
    • Effects
      • Loss of electrolyte balance
      • Build up of toxic urea in the blood
      • High blood pressure
      • Weakened bones
      • Pain and stiffness in joints
      • Anaemia
    • Measuring GFR
      • Glomerular Filtration Ratw (GFR)
      • A blood test measures the amount of creatinine in the blood. It is a breakdown product of muscles
      • If the lelvels of creatinine go up it shows tjat the kidneys aren't working properly
      • GFR decreases with age even if you are healthy,
      • Men usually have more muscle mass and mno9re creatinine than women.
    • Haemodialysis
      • Blood leaves patients body throguh an artery it then flows into the dialysis machine
      • In the dialysis machine it flows between partially permeable dialysis membranes.
      • The membranes mimic the basement membrane of the bowmans capsule
      • Dialysis fluid is on the other side of the memrbane
      • During dialysis patients must lose excess urea and mineral ions but not important substances.
        • the loss of these is prevented by monitoring the dialysis fluid so there is no net movemnet of glucose out for example Th
      • There should be no concentration gradient for suseful substances between the blood and dialysis fluid.
      • Blood and dialysis fluid move in opposite directions to maintain a counter-current exchange system
      • No active transport it purely depends on how steep the concentration gradients are
      • External
    • Peritoneal Dialysis
      • Internal
      • Makes use of the peritoneum an
      • Dialysis fluid is introduced into the abdomen using a catheter before it is left for several hours.
      • Fluid is eventually drained off and discarded it leaves the blood balanced again.
      • Urea and excess mineral ions are removed
    • Transplant
      • Single healthy kidney is placed in the body
      • Blood vessels are joined and ureter of the new kidney is inserted into the bladder
      • High risk of rejection as the antigens on the donor organ differ to those on the cells of the recipient
        • To minimise this the kidney and donor are matched as much as possible
        • The recipient is given immunosuppressant drugs for the rest of their lives
      • Transplanted organ do not last forever


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