Altered Renal Fx Flashcards
(35 cards)
Difine Glomerular filtration rate (GFR)
An estimate of how much blood passes through the
glomeruli each minute
Urine output for normal, Polyuria and Oliguria
Normal 1000-1800 L/day
Polyuria over 2.5 L/day
Oliguria under 500 L/day, ie < 0.5 ml/kg/hr
Name Renal function tests
Creatine levels
ACR (albumin-to-creatinine ratio) - Less than 30
Urine culture
Specific gravity
Name 5 Renal function diagnostics
- Renal Ultrasound
- Duplex ultrasound or angiography or spiral CT
- Cystoscopy
- Renal Scan
- Intravenous Pyelogram (IVP)
Define Urinary Tract Obstruction
and Causes
interference with the flow of urine at any site along the urinary tract
- anatomical: stricture or narrowing of the lumen
- functional: neurological defect
What are Renal calculi?
Crystals, protein or other substances that form in the kidneys and may obstruct the (upper) urinary tract.
Kidney calculi formation
1 - Precipitation of salts from liquid to solid state
2 - Salts crystallise forming a nidus/seed around
which the stone forms
What are the clinical manifestations of Kidney calculi?
- Renal (ureteric) colic
- Haematuria
- Nausea and vomiting
- Fever
- Chills
- WBC’s in urine
What does the lower urinary tracts consists of?
- ureters
- urinary bladder
- urethra
Define Hydronephrosis
Distention and dilation of the renal pelvis and calyces, usually caused by obstruction of the free flow of urine from the kidney
Hydronephrosis: Causes
- Intrinsic
- Extrinsic: pregnancy, uterine prolapsed, prostate hypertrophy
- Functional: Neurologic
Define Urinary Tract infection (UTI)
Inflammation of the urinary epithelium caused by bacteria
Bacterial diseases in Upper and Lower Urinary Tract
ie UTI
Upper urinary tract - Pyelonephritis - Ureteritis Lower urinary tract - Urethritis - Cystitis - urinary bladder - Prostatitis
Name the 2 UTI most common pathogens
- Escherichia coli
* Staphylococcus aureus
Define the upper UTI Acute Pyelonephritis
Name 3 Bacteria
Infection of the renal pelvis and interstitial
- E. coli
- Proteus
- Pseudomonas
Acute Pyelonephritis: Diagnoses
- Urine culture
- Urinalysis - *White blood cell casts in urine
- Increase ESR and C-reactive protein levels
- Increase creatinine
- Clinical signs and symptoms
When does Acute Pyelonephritis turns into Chronic Pyelonephritis?
When there is a persistent or recurrent infection of the kidney (same organism) resulting in inflammation and scarring
What is the Normal Glomerular Filtration Rate (GFR)? And how much is reabsorbed?
(GFR) is 125 ml/minute of which 124 ml is reabsorbed
What are the clinical manifestations of Glomerular disorders?
- hypertension
- oedema
- elevated blood urea nitrogen (BUN)
- Decreased glomerular filtration rate
- Elevated plasma creatinine and urea
- Reduced creatinine clearance
- proteinuria (increased permeability of glomerular capillaries)
What is Acute Glomerulonephritis and what causes it?
Immune-complex hypersensivity reaction (inflammation) to streptococcal infection elsewhere in the body. It causes gram negative septicaemia. For eg group A streptococcal infection of the throat
Glomerulonephritis: Pathophysiology
Streptococcal infection of the skin or pharynx
• Depositing antibody-antigen complex on the BM in glomeruli
• Complement activation and inflammatory reaction
• Damage to surrounding tissue
- Decreases blood flow and GFR, while a increasing BM permeability
What characterises Glomerulonephritis in children?
Acute poststreptococcal
Deposition of mainly IgA and some IgM antibodies and complement into the glomerular capillaries
Define Chronic Glomerulonephritis
Progressive hardening and scarring of the basement membrane in the glomerulus, and with tubular injury
Chronic Glomerulonephritis:
Pathophysiology
Loss of plasma protein (albumin) causes decreased oncotic pressure -> generalised oedema
• Decreased circulating blood volume activates the reninangiotensin system
• retention of sodium and further oedema
