Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pathophysiology > 28 Acute Kidney Injury and Chronic Kidney Disease > Flashcards

28 Acute Kidney Injury and Chronic Kidney Disease Flashcards

(69 cards)

Start Studying
1
Q

Acute Kidney Injury fka…

A

Acute Kidney Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute Kidney Injury

A

sudden reduction of kidney function

  • causes DECREASED GFR
  • reults in characteristic alterations in laboratory blood + urine tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Decreased Glomerular Filtration Rate [GFR]

A
  • urine output
  • retention of nitrogenous waste
  • incr serum creatinine
  • disrupt in fluid, electrolyte, + acid=base balance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

renal function is monitored by ___

A

calculated by SERUM CREATININE + calculated GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

retention of AZOTEMIA/UREMIA (metab waste) is monitored by

A

BUN

-produces widespread systemic effects- [UREMIC SYNDROME]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 sites of disruption

A

1 PRERENAL
2 POSTRENAL
3 INTRINSIC/INTRARENAL

-distinction bw sites of disruption helps determine appropriate therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PRERENAL disruption

A

renal perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

POSTRENAL disruption

A

urine flow distal to the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

INTRINSIC/INTRARENAL disruption

A

circumstances w/in kidney blood vessels, tubules, glomeruli, or interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prerenal Kidney Injury

A

due to conditions that diminish perfusion of kidney

-prolonged prerenal ARF leads to acute tubular necrosis (intrinsic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Prerenal Kidney Injury

causes

A
  • hypovolemia, hypotension, HF
  • renal artery obstruction
  • fever, vomit, diarrhea
  • burns
  • overuse of diuretics
  • edema, ascites
  • drugs ACE inhibitors, angiotensin II blockers, NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prerenal Kidney Injury

s/s

A
  • low GFR
  • oliguria
  • high urine specific gravity
  • high osmolarity
  • low urine sodium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

prolonged PRERENAL ARF leads to…

A

Acute Tubular Necrosis [ATN]

—-intrinsic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Post Renal Kidney Injury

A

due to OBSTRUCTOIN w/in urinary collecting system DISTAL to the kidney
-clinical findings are based on duration of obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post Renal Kidney Injury

effects

A
  • elevated prssure in Bowman capsule

- impedes flomerular filtration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Intrinsic/Intrarenal Kidney Injury

A

due to DYSFUNCTION OF THE NEPHRONS + kidney itself

  • most common problem w/in renal tubules
  • —-results in [ATN]
  • —-may also occur w glomerular, vascular, or interstitial etiologies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute Tubular Necrosis [ATN]

causes

A

1 nephrotoxic insult (contrast media)

2 ischemic insult (sepsis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intrinsic/Intrarenal Kidney Injury

2 pathophysiological processes

A

1 Vascular process

2 Tubular process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vascular pathophysiological processes

A

DECREASE in renal blood flow
-hypoxia, vasoconstriction

1 of 2 intrinsic/intrarenal kidney injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tubular pathophysiological processes

A

INFLAMMATION + reperfusion injury
-casts, obstructs urine flow, tubular backleak

1 of 2 intrinsic/intrarenal kidney injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Intrinsic/Intrarenal Kidney Injury

self-limiting

A

can repair itself (self-limiting)

or if injury is sustained, leads to end-stage renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute Tubular Necrosis [ATN]

3 phases

A

1 Prodromal
2 Oliguric
3 Post-Oliguric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acute Tubular Necrosis [ATN]

clinical presentations

A

varies by each phase (3)

-lab findings can help differentiate prerenal from intrinsic/intrarenal kidney injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Prodromal Phase of ATN

A
  • injury has occured
  • normal or decr UO
  • incr BUN + Cr

-usually asymptomatic bc normal UO + normal GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Oliguric Phase of ATN
- oliguria/anuria - Vol overload - hyPERkalemia>metab acidosis - azotemia/uremia - hypervolemia>edema - uremic syndrome
26
Post-Oliguric Phase of ATN
- fluid vol deficit | - labs begin to normalize
27
Renal Function Recovery
- incr DIURESIS - tubular function impaired (GFR + urine quality) - azotemia continues
28
diuresis
amount of urine produced in a given time
29
oliguria
DECREASED diuresis/UO
30
anuria
NON-urination
31
azotemia
- Waste products remain in the blood - Little or no urine is produced, although the kidney itself is working - When nitrogenous wastes, such as creatinine and urea, build up in the body, the condition is known as azotemia
32
uremia
disorder of kidney function that occurs when the kidneys can not properly remove urea from the body -urine waste accumulate in the blood and can be another set of diseases.
33
normal urine output
800-2,000 ml/day
34
oliguric urine output
<400 ml/day usually 50-400ml
35
anuria urine output
<100 ml/day
36
uremic syndrome
fatigue, nausea, loss of appetite, a metallic taste in the mouth and mental confusion
37
Chronic Kidney Disease [CKD]
- outcome of progressive + IRREVOCABLE LOSS OF FUNCTIONAL NEPHRONS - DECREASED kidney function or damage of 3 months - GFR<60ml/minute/1,73cm for 3 months
38
Chronic Kidney Disease [CKD] | progressive process
1 Chronic Kidney Disease [CKD] 2 Chronic Renal Failure [CRF] 3 End-Stage Renal Disease [ESRD] ESRD requires dialysis
39
how many functional nephrons are lost to be CKD?
more than 75% of nephrons lost
40
Chronic Kidney Disease [CKD] | diagnosis
- blood test - urinalysis - imaging studies
41
CKD is a global health problem that is often linked w...
linked w hypertension, diabetes mellitus + other comorbidities
42
what is GFR rate in CKD?
GFR<60ml/minute/1,73cm for 3 months
43
Chronic Kidney Disease [CKD] | risk factors
``` 1 diabetes 2 hypertension 3 recurrent pyelonephritis 4 glomerulonephritis 5 polycystic kidney disease 6 fam hx of CKD 7 hc of exposure to toxins 8 >65 yrs old 9 ethnicity ```
44
kidneys compensate for CKD until...
75-80% of nephrons are damaged/nonfunctional
45
progression of CKD is ____ + ____
progressive + irreversible
46
Chronic Kidney Disease [CKD] | staging
- progression monitored by staging systm - ---based on incr severity - 5 stages of progression - --each higher stage has further declining GFR + kidney function
47
<75% nephron loss
Stage: DECREASED RENAL RESERVE - no s/s, - normal BUN + creatinine
48
75-90% nephron loss
Stage: RENAL INSUFFICIENCY - polyuria, nocturia - slight elevation in BUN + creatine - may be controlled by diet + medication
49
<90% nephron loss
Stage: ESDR - azotemia/uremia - fluid/electrolyte abnormalities - osteodystrophy - anemia - dialysis or transplant is critical
50
Stage 1 CKD
kidney damage w norm or incr GFR GFR >90 mL/min/1.73cm
51
Stage 2 CKD
mildly decr GFR GFR 60-89 mL/min/1.73cm
52
Stage 3 CKD
moderately decr GFR GFR 30-59 mL/min/1.73cm
53
Stage 4 CKD
severely decr GFR GFR 15-29 mL/min/1.73cm
54
Stage 5 CKD
ESRD GFR <15 mL/min/1.73cm
55
Chronic Kidney Disease [CKD] | complications
``` 1 hypertension + cardiovascular disease 2 uremic syndrome 3 metab acidosis 4 electrolyte imbalance 5 bone + mineral disorder 6 malnutrition 7 anemia 8 pain 9 depression ```
56
hypertension + cardiovascular disease in CKD
-hypervolemia, escalated atherosclerotic process, heightened RAAS + SNS activity
57
uremic syndrome in CKD
retention of metabolic wastes - impaired healing - pruritus - dermatitis - uremic frost
58
metabolic acidosis of CKD
retention of acidic waste products - hyperkalemia - kidneys lose ability to secrete H+ ions + bicarbonate
59
electrolyte imbalance of CKD
retained K, phosphorous, Magnesium
60
electrolyte imbalance of CKD | mgmt
- fluid restriction if Na <135mmol/L - if edema/HF/hypertension, may need 2g/day Na - mild hyperkalemia (<6mmol/L): reduce K intake, correct merab acidosis - K level >6mmol/L: IV Ca gluconate, D5W, + insulin; oral/rectal Na polystyrene sulfonate - protein restriction
61
Bone + Mineral Disorders of CKD
- elevated phosphorous + PTH causes altered bone/mineral metabolism - kidneys unable to produce active vit D(1,25-ch-vITC) - ----prevents reabsorption of Ca in sm. intestines
62
Bone + Mineral Disorders of CKD | mgmt
- PTH, Ca, phosphorous should be monitored if GFR <60mL/min/1.73cm - hypocalcemia: Ca carbonate, Ca acetate, lanthanum carbonate - Vit D for deficiency + suppress PTH - calcimimetics suppress PTH
63
Anemia of CKD
lack of erythropoietin - uremia shortens RBC life - Cardiorenal Anemia Syndrome
64
Cardiorenal Anemia Syndrome
combo of worsening CKD, anemia, + HF
65
Dialysis
used for ATN + CKD stage 5 | ---removed metab wastes + correct fluid electrolyte abnormalities
66
types of Dialysis
1 hemodialysis | 2 peritoneal dialysis
67
what should be monitored if GFR<60ml?
PTH, Ca, phosphorous
68
protein restriction is for _____
fluid electrolyte imbalances
69
CKD is based on...
% nephons lost or GFR (5 stages)

Pathophysiology (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions