1. Kidney Failure 1

3. Removing nitrogenous waste products

4. Excess water & mineral salts

5. As osmoregulators: Kidney regulates salt & water balance  also indirectly control blood pressureURINE

6. Kidney failureWhy kidney failure? High blood pressure Diabetes Long term drinking of alcoholic beverages Major surgery / accidents

7. Kidney failurePossible cure / treatment? Kidney transplant Dialysis Haemodialysis using Dialysis machine Peritoneal dialysis using membranes/bag

8. Dialysis 5

9. Differences between haemodialysis and peritoneal dialysis

10. artery How Is Blood Cleaned in a Dialysis Machine? 1 Blood is drawn from an artery in the patient’s arm 1 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 7

11. artery dialysis tubing dialysis fluid fresh dialysis fluid dialysis machine How Is Blood Cleaned in a Dialysis Machine? 1 Blood is pumped through a tubing to the dialysis machine Blood is drawn from an artery in the patient’s arm 1 2 2 pump 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 8

12. artery dialysis tubing dialysis fluid fresh dialysis fluid dialysis machine How Is Blood Cleaned in a Dialysis Machine? 1 Blood is drawn from an artery in the patient’s arm Blood is pumped through a tubing to the dialysis machine 1 2 2 The tubing is bathed in a special dialysis fluid and the tubing is semi-permeable 3 pump 3 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 9

13. artery dialysis tubing dialysis fluid fresh dialysis fluid dialysis machine How Is Blood Cleaned in a Dialysis Machine? 1 Blood is drawn from an artery in the patient’s arm Blood is pumped through a tubing to the dialysis machine 1 2 2 The tubing is bathed in a special dialysis fluid and the tubing is semi-permeable 3 4 pump Small molecules (e.g. urea) and metabolic waste products diffuse out of the tubing 4 3 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 10

14. artery dialysis tubing dialysis fluid fresh dialysis fluid dialysis machine How Is Blood Cleaned in a Dialysis Machine? 1 Blood is drawn from an artery in the patient’s arm Blood is pumped through a tubing to the dialysis machine 1 2 2 The tubing is bathed in a special dialysis fluid and the tubing is semi-permeable 3 4 pump 5 Larger molecules (e.g. plates and blood cells) remain in the tubing Small molecules (e.g. urea) and metabolic waste products diffuse out of the tubing 5 4 3 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 11

15. artery vein dialysis tubing dialysis fluid filtered blood fresh dialysis fluid dialysis machine How Is Blood Cleaned in a Dialysis Machine? 1 Blood is drawn from an artery in the patient’s arm Blood is pumped through a tubing to the dialysis machine 1 2 6 2 The filtered blood is returned to a vein in the patient’s arm The tubing is bathed in a special dialysis fluid and the tubing is semi-permeable 6 3 4 pump 5 Larger molecules (e.g. plates and blood cells) remain in the tubing Small molecules (e.g. urea) and metabolic waste products diffuse out of the tubing 5 4 3 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 12

16. Exchange of Substances between the Blood and the Dialysis Fluid Patient’s blood enters dialysis machine dialysis machine partially permeable membrane dialysis fluid patient’s blood 1 essential mineral salt 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 13

17. Exchange of Substances between the Blood and the Dialysis Fluid Patient’s blood enters dialysis machine urea molecule dialysis machine partially permeable membrane dialysis fluid patient’s blood 1 2 dialysis fluid red blood cell essential mineral salt protein molecule Blood flows in the opposite direction to flow of dialysis fluid 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 14

18. Exchange of Substances between the Blood and the Dialysis Fluid Dialysis fluid contains the same concentration of essential substances as blood. No metabolic wastes present Patient’s blood enters dialysis machine dialysis machine urea molecule partially permeable membrane dialysis fluid patient’s blood 1 2 dialysis fluid red blood cell essential mineral salt protein molecule Blood flows in the opposite direction to flow of dialysis fluid 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 15

19. Exchange of Substances between the Blood and the Dialysis Fluid Dialysis fluid contains the same concentration of essential substances as blood. No metabolic wastes present Patient’s blood enters dialysis machine dialysis machine urea molecule partially permeable membrane dialysis fluid patient’s blood 1 2 3 dialysis fluid red blood cell essential mineral salt protein molecule Concentration gradient set up between dialysis fluid and blood Blood flows in the opposite direction to flow of dialysis fluid 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 16

20. Exchange of Substances between the Blood and the Dialysis Fluid Dialysis fluid contains the same concentration of essential substances as blood. No metabolic wastes present Patient’s blood enters dialysis machine dialysis machine partially permeable membrane dialysis fluid patient’s blood 1 2 4 3 dialysis fluid with waste products dialysis fluid urea molecule red blood cell essential mineral salt protein molecule Concentration gradient set up between dialysis fluid and blood Blood flows in the opposite direction to flow of dialysis fluid Removal of metabolic waste products from the blood 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 17

21. Exchange of Substances between the Blood and the Dialysis Fluid Dialysis fluid contains the same concentration of essential substances as blood. No metabolic wastes present Patient’s blood enters dialysis machine Filtered blood is returned to the patient dialysis machine partially permeable membrane dialysis fluid patient’s blood filtered blood 1 5 2 4 3 dialysis fluid with waste products dialysis fluid urea molecule red blood cell essential mineral salt protein molecule Concentration gradient set up between dialysis fluid and blood Blood flows in the opposite direction to flow of dialysis fluid Removal of metabolic waste products from the blood 3 October 2011 Copyright © 2006-2011 Marshall Cavendish International (Singapore) Pte. Ltd. 18