w2 CKD Flashcards
what are some nephrotoxic medications that can induce CKD
NSAIDs:
- Lithium
- Proton pump inhibitors:
define Pollakiuria
Abrupt onset of severe urgency as often as every 10-15
minutes during the day. Occurs without dysuria, UTI, daytime incontinence, or nocturia. Most commonly in 4-6 year-old males. Symptoms typically occur with anxiety and stress, though pinworms and increased dietary sodium or calcium may be factors. Typically resolves within 2-3 months of onset
define Dysuria
urning or discomfort during voiding.
Typically caused by inflammatory processes.
Cystitis represents 50-60% of dysuria. Can also
represent upper urinary tract disease such as
pyelonephritis and STDs. In older men,
prostatitis is the most likely cause. In younger
men, urethritis is the most common etiology.
define Anuria
Between 0-50 mL of urine output per
day. Caused by a low GFR due to decreased
renal blood flow or obstruction in the kidney or
ureter. Bladder outlet obstruction is the most
common cause.
define Oliguria
Between 51-400 mL of urine output per day. Caused by a low GFR due to decreased renal blood flow or obstruction in the kidney or ureter. Bladder outlet obstruction is the most common cause.
define pruritus
uncomfortable sensation that gives the patient the urge to scratch
define Uremic neuropathy
(occurs in patients with severely decreased renal function that has persisted a more than 6 months) earliest symptom = paresthesia; then weakness and atrophy +difficulty concentrating, lethargy, and confusion
what are the symptoms of renal failure
anemia heart failure uremic neuropathy edema hypertension uremia fatigue vomitting sleep disturbances jugular venous distention
what is the mechanism behind uremic frost
Increased BUN levels→increased concentration of urea in sweat
Evaporation of sweat with high urea leaves a crystal deposit on the skin
what causes Asterixis
-uremic neuromuscular disturbance that is a result of encephalopathy; exact pathophysiology unknown Hypothesis: guanidino susbtances or PTH changing brain calcium level
what are some drugs you can administer other than ace/ arbs in CKD
b blockers
diuretics
what could elevated uric acid in the urine suggest
Often normal, but may be uric acid nephropathy
May also indicate tumor lysis syndrome when seen with AKI
what could Calcium Oxalate in the urinalysis suggest
If present with AKI, may indicate ethylene glycol ingestion (toxic) Risk for calcium stones
what could Magnesium ammonium phosphate in the urinalysis suggest
Infection with microorganisms that produces it Risk for struvite stones
what could hyaline casts in the urinalysis suggest
Composed of Tamm-Horsfall glycoprotein from loop of Henle cells Indicates slow urinary flow (seen in dehydration)
May be only cast seen in prerenal AKI, urinary tract obstruction, tumor lysis syndrome, and others
Patients with CKD: normal urinalysis may indicate persistently decreased circulating volume (heart failure, obstruction, light chain cast nephropathy, ischemic/hypertensive nephrosclerosis)
