2. 1. KIDNEY
FAILURE
Why are kidneys important?
• They are excretory organs, removing
mainly nitrogenous waste products,
excess water and mineral salts in the
form of urine
• Kidneys are osmoregulators. They
regulate the salt and water balance of
the body fluid.
3. What happens when the kidneys
fail?
High blood pressure and diabetes are
causes of kidney failure
Constant heavy drinking of alcohol may
cause kidneys to lose their function
May also occur suddenly or after major
surgery
One kidney failed to function, a person
still can lead a normal life with the other
kidney. If both kidneys fail to work, the
person will die unless prompt medical
treatment is given.
4. 2. KIDNEY DIALYSIS
Patient with kidney failure
can be treated with a dialysis
or kidney machine.
Blood drawn from patient’s
artery flow through tubing
(bathed in a dialysis fluid) in
the machine) walls of
tubing partially permeable
big molecules like protein and
blood cells remain in tubing
5. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
1. Blood is
drawn from an
artery in the
patient’s arm
6. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
2. Blood is
1. Blood is
drawn from an pumped through
artery in the a tubing to the
patient’s arm 2 dialysis machine
7. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
2. Blood is
1. Blood is
drawn from an pumped through
artery in the a tubing to the
patient’s arm 2 dialysis machine
3. The tubing is
bathed in a
special dialysis
fluid and the
tubing is semi-
permeable
3
8. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
2. Blood is
1. Blood is
drawn from an pumped through
artery in the a tubing to the
patient’s arm 2 dialysis machine
3. The tubing is
bathed in a
special dialysis
fluid and the
tubing is semi-
permeable
3
9. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
2. Blood is
1. Blood is
drawn from an pumped through
artery in the a tubing to the
patient’s arm 2 dialysis machine
3. The tubing is
bathed in a
4 special dialysis
fluid and the
tubing is semi-
permeable
4. Small
molecules (e.g.
3 urea) and
metabolic waste
products diffuse
out of the tubing
10. 3. How Is Blood Cleaned
in a Dialysis Machine?
artery 1
2. Blood is
1. Blood is
drawn from an pumped through
artery in the a tubing to the
patient’s arm 6 2 dialysis machine
3. The tubing is bathed in a
special dialy sis f luid and the tubing is semi-permeable
6. The filtered
blood is returned
4
to a vein in the
patient’s arm
5
5. Larger
molecules 4. Small
(e.g. plates molecules (e.g.
and blood 3 urea) and
cells) remain in metabolic waste
the tubing products diffuse
out of the tubing
12. ♥ Exchange of substances between
the blood and the dialysis fluid ♥
Dialysis fluid contains the same concentration
of essential salts as the blood
These salts can diffuse into the blood in the
tubing if the body lacks such salts
Dialysis does not contain metabolic waste
products
Tubing is long, narrow to increase surface area
to volume ratio to speed up rate of exchange of
substances between the blood and dialysis fluid
Treatment is about 2 to 3 times a week,
each time lasting several hours
14. 1. Patient’s blood
enters dialysis
machine
dialysis machine dialysis
partially fluid
permeable
membrane
patient’s blood
1
dialysis fluid
2
protein essential red blood cell
molecule mineral salt
2. Blood flows in the opposite
direction to flow of dialysis fluid
15. 1. Patient’s blood 3. Dialysis fluid contains the same
enters dialysis concentration of essential substances as
machine blood. No metabolic wastes present
dialysis machine dialysis
partially fluid
permeable
membrane
patient’s blood
1
dialysis fluid
3 2
protein essential red blood cell
molecule mineral salt
2. Blood flows in the opposite 4. Concentration
direction to flow of dialysis fluid gradient set up
between dialysis
fluid and blood
16. 1. Patient’s blood 3. Dialysis fluid contains the same 6. Filtered
enters dialysis concentration of essential substances as blood is
machine blood. No metabolic wastes present returned to
the patient
dialysis machine dialysis
partially fluid
permeable
membrane
patient’s blood filtered blood
1 5
dialysis fluid
4 3 2
dialysis fluid with
waste products
urea protein essential red blood cell
molecule molecule mineral salt
5. Removal of 2. Blood flows in the opposite 4. Concentration
metabolic direction to flow of dialysis fluid gradient set up
waste products between dialysis
from the blood fluid and blood
17. ENOUGH OF W ORDS, TIME FOR
SOME VIDEOS TO FIND OUT
ABOUT THE DIFFERENT
TYPES OF DIALYSIS :D
http://www.youtube.com/watch?v
http://www.youtube.com/watch?v
18. 5.What are the different types of dialysis ?
There are two types of dialysis - hemodialysis and peritoneal
dialysis
In hemodialysis, an artificial kidney (hemodialyzer) is used to
remove waste and extra chemicals and fluid from your blood. To
get your blood into it , the doctor needs to make an access into
your blood vessels. This is done by minor surgery to your arm or
leg.
An access is made by joining an artery to a vein under your skin
to make a bigger blood vessel called a fistula.
However, if your blood vessels are not adequate for a fistula,
the doctor may use a soft plastic tube to join an artery and a
vein under your skin. This is called a graft.
In peritoneal dialysis, your blood is cleaned inside your body.
The doctor will do surgery to place a plastic tube called a
catheter into your abdomen to make an access. Extra fluid and
waste products are drawn out of your blood and into the
dialysate.
There are two major kinds of peritoneal dialysis :
_ Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type
of peritoneal dialysis that is done without machines.
_ Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at
home using a special machine called a cycler.
20. 6. WHY MUST THE DIRECTION OF BLOOD
FLOW BE OPPOSITE TO THE DIRECTION OF
FLOW OF THE DIALYSIS FLUID ?
• The direction of blood flow must be opposite to
the direction of flow of the dialysis fluid to
ensure a diffusion gradient remains to allow urea
to flow out.
• This also ensures all the urea in the blood will be
removed. Imagine if they flow in the same
direction, when blood reaches the end, the
dialysis solution is high in urea and so is the blood
and urea will not be removed.
21. 6. After a transplant, will a patient
be able to live a normal life again ?
♥ If the grafted kidney is well-looked after, the
patient can go back to a near normal life that is
productive and of better quality with fewer
restrictions compared to when placed on dialysis
and restrained from eating a normal diet.
23. BECAUSE OF TIME
CONSUMING, LET’S START
WITH $1,000 QUESTION !
QUESTION 1 : WHICH OF THE FOLLOWING IS NOT
THE REASON WHY THE
KIDNEYS IS IMPORTANT ?
B. Regulate the salt
A. Remove waste products
And water balance
C. Regulate water D. Absorb water and
potential of the blood mineral salts
24. ♥♥♥ FOR THOSE WHO CHOOSE
D, YOU’RE CORRECT!
♥ LET’S RECAP -> Kidneys are excretory
organs, removing mainly nitrogenous
waste products, excess water and
mineral salts in the form of urine
♥ Kidneys are osmoregulators. They
regulate the salt and water balance of
the body fluid.
26. LET’S CONTINUE WITH
THE $2,000 QUESTION !
QUESTION 2 : WHICH OF THE FOLLOWING IS NOT
THE CAUSE OF KIDNEY FAILURE?
A. Exercise vigorously B. High blood pressure
C. Constant heavy
D. After a major surgery
drinking
27. ♥♥♥ FOR THOSE WHO CHOOSE
A, YOU’RE CORRECT!
♥ LET’S RECAP :
High blood pressure and diabetes
are causes of kidney failure
Constant heavy drinking of alcohol
may cause kidneys to lose their
function
May also occur suddenly or after
major surgery
28. LET’S
CONTINUE WITH
THE $4,000 QUESTION !
QUESTION 3 : WHAT CAN A PATIENT WITH KIDNEY
FAILURE BE TREATED WITH ?
B. Blood pressure
A. Kidney machine
machine
C. Blood circulation D. Excretion care
machine machine
29. ♥♥♥ FOR THOSE WHO CHOOSE
B, YOU’RE CORRECT!
♥ LET’S SEE :
When kidney function gets to about
15% or less, a person must start
dialysis.
30. LET’S CONTINUE WITH THE $8,000
QUESTION !
WOW, IT’S A KILLER ONE! AFTER THIS WE
WILL PROCESS TO THE $32,000 QUESTION!
QUESTION 4 : A PERSON USUALLY BEGIN
DIALYSIS WHEN THEIR KIDNEY FUNCTION GOES
DOWN TO ABOUT HOW MANY PERCENT ?
A. 50% B. 15%
C. 20% D. 25%
31. ♥♥♥FOR THOSE WHO CHOOSE C,
YOU’RE CORRECT!
♥ LET’S RECAP
- There are two types of dialysis :
hemodialysis and peritoneal dialysis
32. LET’S
CONTINUE WITH
THE $32,000 QUESTION !
QUESTION 5 : WHAT ARE THE TWO TYPES OF
DIALYSIS ?
A. Graft dialysis and B. Catherer dialysis and
Peritoneal dialysis Graft dialysis
C. Hemodialysis and D. Hemodialysis and
Peritoneal dialysis Fistula dialysis
33. ♥♥♥ FOR THOSE WHO CHOOSE
D, YOU’RE CORRECT!
♥ LET’S RECAP :
The catherer that is used for peritoneal
dialysis is place at the abdominal area in
the body
34. LET’S
CONTINUE WITH
THE $64,000 QUESTION !
QUESTION 6 : WHERE IN THE BODY IS THE
CATHETER THAT IS USED
FOR PERITONEAL DIALYSIS ?
A. Arm B. Leg
C. Neck D. Abdominal area
35. ♥♥♥ FOR THOSE WHO CHOOSE
C, YOU’RE CORRECT!
♥ LET’S RECAP :
An access is made by joining an
artery to a vein under your skin to
make a bigger blood vessel called a
fistula
36. LET’S
CONTINUE WITH
THE $125,000 QUESTION !
QUESTION 7 : WHAT IS USED IN HEMOLDIALYSIS
CREATED BY SURGICALLY CONNECTING AN
ARTERY AND VEIN TOGETHER ?
A. Catherer B. Dialysate
C. Fistula D. Artificial kidney
37. ♥♥♥ FOR THOSE WHO CHOOSE
B, YOU’RE CORRECT!
♥ LET’S RECAP :
Excess wastes and water pass from
the blood into a the dialysis fluid for
removal from the body by diffusion.
38. LET’S
CONTINUE WITH
THE $250,000 QUESTION !
QUESTION 8 : WHICH TWO SUBSTANCES WILL
PASS FROM THE BLOOD INTO THE DIALYSIS
FLUID ?
A. Plasma and mineral
B. Water and mineral salts
salts
D. Metabolic wastes and
C. Membrane and water
mineral salts
39. ♥♥♥ FOR THOSE WHO CHOOSE
A, YOU’RE CORRECT!
♥ LET’S RECAP :
The dialysis tubing is bathed in a
special dialysis fluid and the tubing is
semi-permeable
40. LET’S
CONTINUE WITH
THE $500,000 QUESTION !
QUESTION 9 : WHICH OF THE FOLLOWING IS
ONE CHARACTERISTIC PROPERTY OF THE
DIALYSIS TUBING ?
A. Partially permeable B. Thin cell wall
C. Fully permeable D. Lignified cell wall
41. ♥♥♥ FOR THOSE WHO CHOOSE C,
YOU’RE CORRECT!
♥ LET’S RECAP :
The direction of blood flow must be
opposite to the direction of flow of the
dialysis fluid to ensure a diffusion gradient
remains to allow wastes to flow out.
42. WOW! WE’RE ALREADY AT
THE $1,000,000 QUESTION !
QUESTION 10 : WHAT IS THE DIRECTION OF
BLOOD FLOW TO THE FLOW OF THE DIALYSIS
FLUID ?
A. Toward B. To the left
C. Opposite D. To the right