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
B. ADH enters blood capillaries in the posterior pituitary gland and travels to the collecting duct
A. Negative water potential
C. Collecting duct wall becomes more permeable
D. More water reabsorbed into the blood/ less urine produced
F. Osmoreceptors shrink and stimulate neurosecretory cells in hypothalamus
E. Action potential sent down axon of Neurosecretory cells causing the release of ADH

4. Answers
B. ADH enters blood capillaries in the posterior pituitary gland and travels to the collecting duct
A. Negative water potential
F. Osmoreceptors shrink and stimulate neurosecretory cells in hypothalamus
C. Collecting duct wall becomes more permeable
E. Action potential sent down axon of Neurosecretory cells causing the release of ADH
D. More water reabsorbed into the blood/ less urine produced

5. Kidney Failure 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
Questions you may like to ask about kidney failure:
Q. How would you feel about being attached to a kidney machine?

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

9. 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
Q: 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.

10. 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
Important: this topic needs to be handled with sensitivity. Please be aware that some students may have lost a friend or relative in tragic circumstances.
If appropriate, this is a chance to talk about why it is so important for anyone who joins the Organ Donor Register to discuss their decision with their close family.
Many organ donation opportunities are lost because next of kin are unaware of the deceased’s wish to donate, which places doctors in a very difficult position.
Most donor kidneys come from patients who have died while on a ventilator following a severe brain injury.
Q: Why do organs need to be removed from a dead person quickly?
A: Organs are made of living tissue which will die if it is not supplied with oxygen and glucose for cell respiration.

11. 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 ?
Recipient 1:
Recipient 2:
Recipient 3:
Details of the HLA tissue type system fall outside most exam specifications, it’s just the principle that is required for the class activity that follows.

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

13. 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.
Q: 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.

14. 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?
Q: 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. 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.
Q: 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.

16. Construct a table of Advantages and Disadvantages of Kidney Transplants
Important: this topic needs to be handled with sensitivity. Please be aware that some students may have lost a friend or relative in tragic circumstances.
If appropriate, this is a chance to talk about why it is so important for anyone who joins the Organ Donor Register to discuss their decision with their close family.
Many organ donation opportunities are lost because next of kin are unaware of the deceased’s wish to donate, which places doctors in a very difficult position.
Most donor kidneys come from patients who have died while on a ventilator following a severe brain injury.
Q: Why do organs need to be removed from a dead person quickly?
A: Organs are made of living tissue which will die if it is not supplied with oxygen and glucose for cell respiration.

17. Dialysis or Transplant?

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

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

20. Dialysis or Transplant
Required to take immunosuppressants
Q: 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.

21. Dialysis or Transplant
Can be performed at home
Q: 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.

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

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

28. Markscheme

29. Markscheme continued

30. PPQ- Pregnancy Tests
On print outs x2

31. Markscheme 2010

33. Markscheme 2012