Module 2: The Person with Kidney Failure (2)

Transplant, Dialysis or no treatment

Kidney from a blood relative (living donor) Non related living donor A deceased donor from the national transplant list (UNOS)

United Network for Organ Sharing

Transplant is not a cure, it is another form of treatment. May last 5,10,20 years or it may not work at all.

Rejection by the bodys immune system sees the transplant as foreign and attacks it (to lower chance of this, pts take immunosuppressant drugs)

Have side effects that may include weight gain, high bp, and increased risk of infection, diabetes, and certain kinds of cancer.

Each year 100,000 people reach kidney failure and 15,000 kidney transplants are done. Severe shortage of donors means long waits for transplant.

Removes all excess fluid each day Removes waste products each day Controls electrolyte and acid/base balance Controls bp by fluid removal, sodium balance and hormonal action Make erythropoietin Controls ca/phos balance each day Plays a role in hormonal balance Activates vit d

Removes some fluid on treatment days Removes some wastes on treatment days Helps restore electrolyte and acid/base balance Helps control bp by removing fluid and balancing sodium on treatment days Cant make erythropoietin Can change serum ca levels somewhat by adjusting calcium in dialysate, can remove some phos but not as well as kidneys Has little, if any affect on hormones Cannot active vit d

Uses part of the pts own body as a filter-the membrane inside the abdomen called the peritoneum. This lining is full of capillary blood vessels, each of which acts as a tiny filter.

A plastic catheter placed into the abdomen or in a moe round about way in the chest wall (presternal catheter). Some pts cannot have PD due to the inability to put this access in due to body type, scarring, or adhesions from surgery.

Can be done alone, at home or at work allowing pts to fit their treatments into their lives, instead of fitting their lives around dialysis

Allows fewer fluid and diet limits than in center HD

Painful infection called peritonitis which can scar the peritoneum, making pd impossible. Must store a months supply of fluid bags

Peritoneum may lose some ability to filter so may need to switch to HD