Medications affecting the kidneys Flashcards

1
Q

Medication affecting the kidney what can target

A

Elimination
Effect on BP
Effect on fluid status
Electrolytes

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2
Q

When stop methotrexate with eGFR

A
  • Review if eGFR <45
  • Stop if <30
  • Prescribe with caution if rapid change in GFR
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3
Q

Why cant take sulfonylureas with kidney disease

A

Increased half life as not cleared -> hypoglycaemia

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4
Q

Trimethoprim and kindneys

A
  • Increase risk hyperkalemia
  • Cretinine serum increase (increased tubular secretion)
  • May → false positive AKI diagnosis due to raised creatinine levels
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5
Q

Solutes absorbed by kdineys

A
  • Sodium
  • Potassium
  • Bicarbonate
  • Chloride
  • Amino acids
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6
Q

Diseases casing CKD

A
  • Diabetes
  • HPTN
  • Vascular disease
  • MI, CVD, PVD
  • BPH
  • Recurrent UTI - chronic pyelobephritis
  • Rexurrent kidney stones - nephrocalcinosis
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7
Q

Diseases causing AKI

A
  • SLE
  • Vasculitis
  • Infections - HepB/C, HIV
  • Myeloma
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8
Q

Causes of oliguria <300ml a dya

A
  • Nephirtic syndrome
  • Acute renal failure
  • Chronic end satge renal fialure
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9
Q

ANuria causes

A
  • Conplete obstruction
  • Vascular catastrophe
  • Acute cortical necrosis
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10
Q

Causes of polyuria

A
  • Diuretics
  • Reduced ADH secretion
    • Cranial diabetes insipidus
    • Aclohol
  • Insensitivity to ADH
    • Nephrogenic diabetes insipidus
  • Psychogenic polydipsia
  • Atrial naturitic peptide (ANP) release
    • Cardiac arrhytmias
    • Cardiac failure
  • Osmotic diuresis
    • Hyperglycaemia
    • Hypercalcuria
  • CKD
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11
Q

Causes of nocturia

A
  • CKD
  • Conditions with osmotic agent in urine eg glucose in DM
  • Prostatic disease
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12
Q

What colour is wee in nephritic sundrome

A

Cola

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13
Q

What does tea coloured urine occur in

A

Myoglobinuria - secondary to rhabdomyolysis

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14
Q

What does hyperphosphatemia cause

A
  • itchiness, lethargy
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15
Q

What does if HPTN, anaemia, uraemia or hyperphosphatemia suggest

A

Kidney cant perform basic tasks

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16
Q

How do nsaids affect the kidneyd

A
  • Impair renal autoregulation bu inhibiting prostaglandin mediated vasodialation of afferent arteriole
  • Reduced blood supply
17
Q

What is the danger of using ACEis/ARBs and NSAIDs

A

NSAIDs reduce Q in afferent glomerulus
ACEis/ARBs reduce Q ine fferent
-> reduced flow in and out of kidneys

18
Q

What does metformin increase the risk of in renal imparment

A

Lactic acidosis

19
Q

What eGFR stop metformin iwth

A

<45 review
<30 STOP
Caustion if rapid eGFR cahgne