1. Kidney Failure

2. 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

3. Put the statements into order A. Negative water potential F. 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 duct C. Collecting duct wall becomes more permeable D. More water reabsorbed into the blood/ less urine produced

4. Answers A. Negative water potential F. 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 duct C. Collecting duct wall becomes more permeable D. More water reabsorbed into the blood/ less urine produced

5. Kidney Failure Most common causes Diabetes Mellitus (type I and type II) Hypertension Infection

6. Kidney failure You 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

7. Task In pairs students given info on either peritoneal dialysis or heamodialysis. They must pick out 5 key points and write them down. One of the pair then remains to explain while the other goes to collect info on other form of dialysis. They then report back to their partner

8. Dialysis http://www.youtube.com/watch?v=W ZosHub0MOQhttp://www.youtube.com/watch?v=W ZosHub0MOQ http://www.kidneypatientguide.org.uk /pd.php

9. 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

10. Matching donor organs to recipients – Human Leukocyte Antigen (HLA ) tissue type A kidney donor needs to be a close HLA type match with the recipient. HLA type can make the difference between a patient’s body accepting or rejecting a donated organ. HLA type is defined by six principal pieces of protein: HLA antigens. Each newly discovered HLA antigen has been numbered. Doctors aim for at least a four HLA match between a donor and patient. Which of these donors is the best match for someone in need of a kidney transplant, with HLA numbers 2 3 6 9 10 13? Recipient 1: 2 6 7 10 11 13 Recipient 2: 3 6 8 9 11 12 Recipient 3: 2 6 9 10 12 13

11. Task Write 6 numbers between 1 & 13 in a line on your mini whiteboard That is your HLA type, can you find a match?

12. 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.

13. 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?

14. 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.

15. Construct a table of Advantages and Disadvantages of Kidney Transplants AdvantageDisadvantage

16. 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 https://www.organdonation.nhs.uk

17. DIALYSIS OR TRANSPLANT?

18. Dialysis or Transplant No longer consider yourself as chronically ill

19. Dialysis or Transplant Have to carefully monitor your diet and fluid consumption

20. Dialysis or Transplant Required to take immunosuppressants

21. Dialysis or Transplant Can be performed at home

22. Dialysis or Transplant Uses the peritoneum to filter the blood

23. Urine Testing SC: Describe how urine samples can be used to test for pregnancy and detect misuse of anabolic steroids Use the Textbook to create a summary for how urine can be tested for: –Pregnancy –Anabolic Steroids

24. PLENARY PPQS

25. PPQ Kidney Failure On print out

26. Markscheme

29. Markscheme continued

30. PPQ- Pregnancy Tests On print outs x2

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