Treatments for kidney failure

• What are the treatments for kidney failure?

  • using drugs to reduce blood pressure
  • regulating potassium levels
  • regulating calcium levels
  • kidney transplants
  • peritoneal dialysis
  • haemodialysis
• What drugs are used to reduce blood pressure and therefore treat kidney failure?

  1. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: reduce the effect of angiotensin, a hormone that constricts blood vessels and increases blood pressure
  2. Calcium channel blockers: dilates blood vessels and reduces blood pressure
  3. Beta blockers: reduce the effect of adrenalin, which increases blood pressure
• How are potassium levels normally regulated?

  By absorption in the small intestine and selective reabsorption in the nephrons
• How are high potassium levels treated in kidney failure patients?

  By a combination of glucose and insulin
• What are the consequences of high calcium levels in the blood?

  • increased risk of heart disease
  • kidney stones
  • osteoporosis
• How are high calcium levels treated in kidney failure patients?

  Biphosphonates: they decrease the activity of osteoclasts, the cells that break down bone. Calcium therefore accumulates in bone, and less circulates in the blood
• How do dead/living kidney donors affect the recipient?

  • a kidney from a live donor works immediately and lasts longer
  • a kidney from a deceased donor may take a few days/weeks to work and dialysis is used meanwhile
• How are donor kidneys matched to recipients?

  Donors and recipients must have compatible blood groups and HLA's (human leucocyte antigens)
• How is the transplanted kidney placed in the recipient?

  • placed in the lower abdomen in the groin
  • the renal artery/vein are attached to the iliac artery/vein
• Why do kidney transplant patients take immunosuppressants?

  • to treat autoimmune diseases/responses
  • with a suppressed immune system, patients are more susceptible to infections of the urinary tract, which can eventually damage the kidney
• How does peritoneal dialysis work?

  • patient drains a bag of dialysis fluid through a catheter in the abdomen into the body cavity
  • the peritoneum is the membrane lining the body cavity, and it has a rich capillary supply
  • the peritoneum acts as the dialysis membrane and materials are removed from the blood in the capillaries into the dialysis fluid
• How does haemodialysis work?

  • blood is taken from an artery and is run through selectively permeable dialysis tubing surrounded by dialysis fluid
  • pores in the dialysis tubing let molecules in solution out into the fluid but not large proteins or blood cells
  • this is a counter current mechanism which enhances diffusion
  • heparin is added to prevent blood clotting