Kidney Failure

Learning Objective

Success Criteria• To know about kidney failure

• Outline the problems that arise from kidney failure and discuss the use of renal dialysis and transplants for the treatment of kidney failure

• Describe how urine samples can be used to test for pregnancy and detect misuse of anabolic steroids

Put the statements into order

A. Negative water

potential

F. Osmoreceptors shrink

and stimulate

neurosecretory cells in

hypothalamusE. Action potential sent

down axon of

Neurosecretory cells

causing the release of

ADH

B. ADH enters blood

capillaries in the

posterior pituitary gland

and travels to the

collecting ductC. Collecting duct wall becomes more permeable

D. More water reabsorbed into the blood/ less urine produced

AnswersA. Negative water potentialF. Osmoreceptors shrink and stimulate neurosecretory cells in hypothalamus

E. Action potential sent down axon of Neurosecretory cells causing the release of ADH

B. ADH enters blood capillaries in the posterior pituitary gland and travels to the collecting ductC. Collecting duct wall becomes more permeableD. More water reabsorbed into the blood/ less urine produced

Kidney Failure

Most common causes• Diabetes Mellitus (type I and type II)• Hypertension• Infection

Kidney failureYou have two kidneys, but you can manage with just one.But if both kidneys fail, urea (waste) rises and the body is poisoned.So if your kidneys fail, there are 2 options:

Option 1: Dialysis• You are attached to a kidney machine via a tube from a vein.

• Your blood flows into the machine, is cleansed, and returns to your body.

• You are attached for about 5 hours, 3 times per week.

Option 2: A kidney transplant• You have an operation to remove your failed kidney and replace it

with a working kidney from a donor.

• One or both kidneys may need to be transplanted

Dialysis

• http://www.youtube.com/watch?v=WZosHub0MOQ

• http://www.kidneypatientguide.org.uk/pd.php

Where do the donor kidneys come from?

• A living person can donate one kidney.

• To donate a kidney (or any organ) after death, you have to have died in hospital – they have to be removed quickly.

• Most people die at home so there is a serious shortage of donor kidneys for transplant.

• There are around 7,000 people waiting for a kidney transplant.

• Around 2,000 kidney transplants are carried out annually and each year 2,000 more people go on the kidney transplant list

Dialysis or transplant?

• Kidney dialysis works quite well, but is a time-consuming burden.

• Apart from taking drugs to stop their body rejecting the new kidney, someone with a successful transplant can lead a completely normal life.

• A transplant costs about £42,000 for the operation plus £6,500 a year in drugs and check-ups.

BUT

• Dialysis isn’t cheap – about £23,000 per year, for life.

Dialysis or transplant?

Q. How long after a transplant would it be before the NHS starts saving money, compared to keeping the patient on dialysis?

Q: If a 20 year old has a kidney transplant and lives to 80, roughly how much money would the NHS save?

Dialysis or transplant?How long after a transplant would it be before the NHS starts saving money, compared to keeping the patient on dialysis?

A: About two and a half years.

Q: If a 20 year old has a kidney transplant and lives to 80, roughly how much money would the NHS save?

A: Cost of dialysis: 60 years x £23,000 = £1,380,000. Cost of transplant: (60 years x £6,500) + £42,000 = £432,000. Saving: £948,000 – roughly one million pounds.

Construct a table of Advantages and Disadvantages of Kidney Transplants

Advantage Disadvantage

Are you an organ donor?

• 16,487,373 people – 27% of the population are

• 90% of people in the UK say they support organ donation

• https://www.organdonation.nhs.uk