腹膜透析原理1.ppt

How PD works 腹透原理 Baxter Asia Renal Kidney Disease肾脏病基础 Implications Therapy options 包括治疗选择 Pr Max Dratwa H?pital Brugmann Brussels Learning objectives学习目的 Understand normal kidney anatomy functioning Understand kidney disease: acute and chronic Know the implications of kidney disease Be able to discuss the different treatment options 理解肾脏正常的解剖和功能 理解急性和慢性肾脏疾病 了解肾脏病的并发症 讨论不同的治疗方式 Functions of the kidney肾功能 Homeostasis = maintenance of equilibrium in terms of : Salt and water (blood pressure) Electrolytes (K, Mg,…) Acid-Base balance (pH) Metabolism of waste products Hormone production Active form of Vitamin D (healthy bones) Erythropo?etin (RBC synthesis) Renin-Angiotensin (blood pressure) 内环境稳态 水盐平衡 电解质(K, Mg,…) 酸碱平衡(pH) 废物的代谢 激素生成 活性维生素 D （健康骨） EPO(促进红细胞生成) 肾素－血管紧张素（调节血压） The diseased kidney肾脏疾病 Two types of kidney disease Acute failure…Classified according to site of problem: pre-renal renal post-renal Chronic disease… Classified in 5 stages of increasing seriousness1: 1: mild damage 2: mild decrease of renal function 3: moderate renal insufficiency 4: severe damage 5: end stage renal disease (ESRD) 两种类型 急性:根据病变部位分类 肾前性（肾脏供血障碍） 肾性（肾本身疾病所致） 肾后性（肾的排泄系统阻塞） 慢性:严格按照疾病进展分5期 1: 轻微损害 2: GRF轻度下降 3: GRF中度下降 4: GRF重度下降 5: 终末期肾脏疾病（ESRD 肾功能急骤地、进行性地减退导致的临床症候群 Causes of Acute Kidney Failure 急性肾功能衰竭的原因 “Pre-renal” Usually due to decreased blood flow to the kidneys hemorrhage, gastrointestinal bleeding leading to shock burns sepsis emboli, stenosis, occlusion, trauma to renal artery decreased cardiac output congestive heart failure, myocardial infarction Surgery 肾前性 通常是因为肾脏血流灌注减少 出血性疾病导致休克 创伤 败血症 肾动脉狭窄、栓塞、硬化等 心输出量下降 充血性心力衰竭、心肌梗塞 手术 Causes of Acute Kidney Failure 急性肾功能衰竭的原因 “Intra-renal” (continued) Inflammation from bacteria/virus Trauma Immunological and vasculitic diseases Auto-antibodies (Goodpasture’s, LED, Wegener’s,…) Transfusion reactions Vascular disorders hypertension, diabetes Pregnancy disorders pre-eclamp