Flashcards in Chronic & Acute Renal Failure Deck (59):
Do you need ARF to get CRF?
if you have CRF does that mean you had to have ARF?
Renal failure is defined as failure of what?
yes the sooner you treat it the better the outcome
definition of renal failure is how much urine flow per day?
less than 500ml/day
CRF timeline? reversible?
develops over 6 months-years
What is normal GFR /min? /day?
GFR at 65? at 80?
65: 100ml/min 144L/day
80: 75ml/min 108L/day
What is considered significant CRF ____ml/min?
<72L per day
loss of GFR is coupled with loss of?
When do you get endocrine impairment with renal failure?
more so CRF
3 main endocrine impairment with renal failure?
impaired vitamin D activation
decreased erythropoeitin - anaemia
plasma urea for GFR assessment?
what is normal creatinine levels?
equation for creatinine clearance?
UV/P = GFR
Normal hydrostatic pressure in glomerulus is?
when do you no longer filter anything in glomerulus?
ARF: What's more common? oliguria? Anuria?
ARF: GFR falls how?
3 areas of acute renal failure?
what is ATN?
acute tubular necrosis
in pre-renal ARF: what would systemic and Glomerulous pressures be less than?
causes of pre-renal ARF? 5 big ones
3 big causes of renal/intrinsic ARF?
what can cause glomerular disease?
IgA immune complexes post group A strep infections
interstitial nephritis often related to?
3 Toxins that can cause tubular damage in ARF?
2 ischemic events that cause tubular damage in ARF? which one is most common?
ATN (most common)
how does ATN cause death?
Acidosis, increase in K+ levels: arrythmias
what is a post-renal cause of ARF?
stones, clots, tumours
What is uraemia?
CRF leads to what?
end-stage renal disease
in CRF what happens to remaining nephrons?
What happens in glomerular hyperfiltration in CRF? 3 things
loss of functional reserve
What is uraemia exactly beside CRF?
accumulation of urea
when do you get symptoms with uraemia?
<30% normal renal function
fatigue, anorexia, skin pigmentation (lemon)
4 common causes of CRF?
high blood pressure
What happens to sodium in glomerular disease?
what happens to sodium in tubular disease
crappy concentrating ability/polyuria
What happens to [K+] in CRF?
tends to rise in late stage
what happens to pH in CRF?
falls cause it fails to excrete
what happens to PO4 in CRF?
rise in PO4
reduction in Ca2+
what happens to Ca2+ in CRF?
rise in PO4
What is renal osteodystrophy?
reduced Vitamin D3 activation: osteomalacia, fractures
why high PTH in CRF?
with less PO4 excretion = increase Ca2+ excretion = increase in PTH to get Ca2+ levels up = hyperparathyroidis (contributes to bone degradation)
Which can be salt and water
imbalances in CRF?
1. Sodium retention and hypertension
2. Sodium wasting and low BP
Impairment of which of the following is the
most important in defining renal failure?
1. renal blood flow
2. glomerular filtration rate
3. renal tubular reabsorption
4. renal tubular secretion
5. renal concentrating ability
Predisposition to acute renal failure is
seen in which of the following groups?
1. < 5 years of age
2. > 60 years of age
5. pre-existing renal disease
Which of the following provide a clinical
estimate of GFR
1. Plasma sodium concentration
2. Plasma potassium concentration
3. Plasma bicarbonate concentration
4. Plasma pH
5. Plasma urea concentration
6. Plasma creatinine concentration
Which of the following scenarios involving
plasma creatinine would worry you?
1. A value of 110 μM/L in a frail old lady
2. A value of 130 μM/L in an elite body builder
3. An increase from 60 to 120 μM/L
4. An increase from 300 to 360 μM/L
Which of the following are true?
1. A urine output of 500 mL per day
excludes the presence of renal failure
Which of the following can cause
pre-renal renal failure?
(via glomerular filtration driving force)
3. Renal artery stenosis
5. ACE inhibitors
6. Cardiac failure
The most accurate measure of
daily fluid balance is:
1. Hospital admission and careful
monitoring of fluid intake and urine
2. Changes in plasma urea
3. Changes in plasma creatinine
4. Jugular venous pressure
5. Daily body weight measurement
Which of the following can cause
2. Interstitial nephritis
3. Renal artery occlusion
4. Prostatic malignancy
Which of the following are problems
in acute renal failure?
4. Sodium and water retention
6. Severe anemia
Which of the following are functions
of the normal kidney?
1. Maintenance of volume of ECF
2. Maintenance of composition of ECF
3. Vitamin D activation
4. Control of red blood cell production
Which of the following would be of
benefit to remaining nephrons
1. High protein diet
2. Low protein diet
3. Keeping blood pressure high
4. Keeping blood pressure low