Renal System

Question 1

Functions of the Renal System (6)

Answer 1

1. Filters fluid from renal blood flow
2. Regulates plasma osmolarity
3. Ensures long term acid-base balance
4. Produces erythropoietin
5. Produces Renin
6. Vit. D synthesis

Question 2

Substances to be excreted in the urine (4)

Answer 2

1. End product (UREA)
2. Hydrogen ions
3. Potassium
4. Phosphates

Question 3

It maintains osmotic pressure / semi permeability of the membranes

Answer 3

Albumin

Question 4

This will happen when hydrogen ions are not secreted

Answer 4

Metabolic acidosis

Question 5

Sequence of RAAS:

Answer 5

(-) BP, (-) CO - Kidneys will release “Renin” + liver will release “Angiotensinogen” = Angiotensin I – ACE (so AI will be converted to A2)

• Adrenal glands will now produce Aldosterone
• Leads to Increase BP

Question 6

ACE is released by?

Answer 6

Lungs

Question 7

Hormone that decreases urine output

Answer 7

Aldosterone

Question 8

Is a potent vasoconstrictor

Answer 8

A2

Question 9

Abrupt loss of kidney function & GFR over a period of hours to days

Answer 9

AKI / Acute Renal Failure

Question 10

3 Classifications of AKI

Answer 10

1. Prerenal Failure
2. Intrarenal Failure
3. Postrenal Failure

Question 11

Other term for Prerenal Failure

Answer 11

Prerenal Azotemia

Question 12

Causes of Prerenal Failure

Answer 12

1. Volume depletion
2. Impaired cardiac deficiency
3. Vasodilation

Question 13

Other terms for Intrarenal Failure

Answer 13

“Intrinsic / Parenchymal Renal Failure”

Question 14

Examples of volume depletion (6)

Answer 14

1. Hemorrhage,
2. burns,
3. frequent diarrhea,
4. ulcerative colitis,
5. vomiting,
6. decreased frequency of urine output (diabetes insipidus)

Question 15

Examples of impaired cardiac efficiency

Answer 15

1. MI
2. HF
3. Cardiogenic shock
4. Arrythmias

Question 16

Causes of Parenchymal Renal Failure (4)

Answer 16

1. Prolonged renal ischemia
2. Rhabdomyolysis
3. Nephrotoxic agents
4. Infections

Question 17

Infections common in Intrinsic RF:

Answer 17

1. Acute glomerulonephritis

2. Acute pyelonephritis

Question 18

Cause of Postrenal RF:

Answer 18

Obstruction

Question 19

Examples of obstruction in Postrenal Failure (4)

Answer 19

1. Benign prostatic hyperplasia
2. Cervical cancer
3. Malignant tumors
4. Hypertrophy

Question 20

4 Phases of AKI

Answer 20

1. Onset
2. Oliguric / Anuric
3. Diuretic
4. Recovery

Question 21

Triggering events of the Onset Phase of AKI:

Answer 21

Blood loss and burns

Question 22

Duration of the Onset Phase:

Answer 22

Hours to days

Question 23

What happens in the Diuretic phase of AKI?

Answer 23

The cause of AKI is being corrected

Question 24

Has tubular scarring and edema

Answer 24

Diuretic Phase

Question 25

Duration of the Oliguric/ Anuric Phase

Answer 25

8-14 days (Depends on the initiation of dialysis (hemodialysis / peritonealdialysis)

Question 26

S/S of the patient in the Oliguric phase (4)

Answer 26

1. Fluid overload
2. Metabolic acidosis
3. F&E imbalance
4. (+) BUN & Creatinine

Question 27

Duration of days in Diuretic Phase

Answer 27

7-14 days

Question 28

Duration of Recovery Stage?

Answer 28

Several months

Question 29

GFR is (– to –%) normal in Recovery stage

Answer 29

70-80%