Renal system

• Antidiuretic hormone (ADH)


  Hormone secreted by the posterior pituitary gland that leads to an increase in reabsorption of water, resulting in an increase in blood pressure
• Chronic kidney disease (CKD) involves gradual loss of kidney function over a period of months or even years
• CKD affects around 10 per cent of the population worldwide
• In 2017, this was over 843 million people globally, and in 2015 it caused 1.2 million deaths worldwide
• Most common causes of CKD

  • Diabetes
  • Hypertension
  • Kidney inflammation (glomerulonephritis)
• Other causes of CKD

  • High cholesterol
  • Kidney infections
  • Autosomal dominant polycystic kidney disease
  • Blockages in the flow of urine
• Treatments of CKD


  • Address the underlying causes of the disease to slow down progression
  • Reduce the symptoms
• Lifestyle changes


  Weight loss and a low-potassium, low-salt diet
• Medications


  • Anti-hypertensives to reduce blood pressure
  • Cholesterol-lowering drugs
• Long-term, regular use of some medicines such as lithium and non-steroidal anti-inflammatory drugs (NSAIDs) can cause CKD
• Symptoms of CKD

  • Swelling (oedema) of ankles, feet and hands
  • Tiredness and shortness of breath
  • Blood in the urine
• Renal dialysis


  Replicates some of the kidney's functions, particularly removal of metabolites and maintaining the correct levels of ions in the blood
• Haemodialysis


  1. Blood is attached to the dialysis machine via the internal fistula into a vein, usually in the arm

  2. A membrane cartridge within the machine replicates the function of the kidney

  3. The process is usually performed in a dialysis centre on a hospital, 3 times a week, with each session lasting about four hours
• Peritoneal dialysis


  1. Uses the peritoneum lining of the abdominal wall as the filtration membrane

  2. A bag of dialysis fluid is attached to a catheter that is permanently inserted into a cut in the abdominal wall

  3. The fluid flows into the abdominal cavity and is left there for about four hours, then it is drained back into the bag and replaced with fresh fluid
• The kidney normally produces vitamin D, which does not happen properly in CKD, leading to disorders of bone metabolism
• Catheter


  A tube inserted into the body to allow the passage of fluids or gases
• Peritoneal dialysis


  A type of dialysis that uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged from the blood
• Patients on dialysis can usually enjoy a reasonable quality of life for many years, depending on their age when they start
• About two per cent of patients with CKD progress to kidney failure
• Although dialysis can keep them alive, these patients are likely to require a kidney transplant
• Living donor

  A person who provides a kidney for transplant, often a close relative
• Living with CKD can have negative effects on a person's mental health
• Healthcare professionals need to take account of the mental health effects and help patients to find a way to incorporate treatment, such as dialysis, into an otherwise fulfilling life