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Flashcards in clinical renal failure & tests Deck (23):
1

defining factor of renal failure

reduction in kidney function = low GFR
(normal GFR = 100ml/min)

2

how can you tell if a patient has kidney failure

blood tests
-creatinine (made from muscles) would be high
-urea

3

factors affecting eGFR

-weight (muscle mass)
-age
-gender

4

what is creatinine a measure for

how much muscle waste is produced and how well the kidneys get rid of that waste product

5

limitations of eGFR

- inaccurate if muscle mass is unusually high or low
- only valid for patients in steady-state

6

define acute kidney injury

- sudden rapid reduction in GFR
- happens over days/weeks
- usually reversible

7

describe causes of pre-renal acute kidney injury and effects

(70% due to non renal causes)
- low BP
- dehydration (signs of JVP)
- septic shock
- hemorrhage

usually low initial urinary output
high creatinine
hyperkalemia
high phosphate
may have low calcium

8

treatment for pre-renal acute kidney injury

fix underlying problem
- rehydrate
- treat bleeding
- fix heart
etc

9

describe renal acute kidney injury and effects on blood test

= acute tubular necrosis (mainly due to pre-renal)
- persistant oliguria & renal failure after correction of pre-renal cause
-may take 4-6 weeks to recover

high creatinine
low urine output
hyperkalemia

10

treatment for renal acute kidney failure

maintain normal BP
treat the underlying problem

if kidneys keep getting worse = dialysis

11

describe polyuric phase in renal acute kidney failure recovery phase

- tubules cant concentrate (urine)
- up to 20L urine a day
- need IV fluids till recovers

when creatinine levels get back to normal they should be able to concentrate their urine again and be back to normal

12

apart from ATN what is another cause of renal acute kidney failure

glomerulonephritis (inflammation of glomerular)
- rapid damage to filtering units
- presents with blood and protein in the urine
- diagnosed by renal biopsy

13

describe causes of post-renal acute kidney injury and effects

- kidney stones
- tumour
- prostate hypertrophy
- urinary retention

can identify by an ultrasound, commonly showing a blockage

14

describe chronic kidney failure and blood tests

- happens over months/years
- gradual decline in renal function
- irreversible

elevated creatinine
elevated urea
usually normal urine output

15

causes of chronic kidney disease

- diabetes
- glomerulonephritis
- hypertension

16

what happens during chronic kidney failure

gradual increase in creatinine due to underlying disease. This causes scarring of glomeruli and interstitium

17

symptoms of chronic kidney failure

- none in early stages (asymptomatic)
- usually found on blood tests
- urine output normal
uremia = symptoms of kidney failure

18

uremic signs

- nausea/vomiting
- itchiness
- SOB
- coma
- Swelling
- anorexia

19

signs of chronic kidney failure

- hypertension
- oedema
- pulmonary oedema
- raised JVP

20

how is chronic kidney failure diagnosed and what are the results

routine blood tests
- increased urea
- increased creatinine
- decreased GFR
- low Hb

21

why do patients with chronic kidney failure become anaemic

kidneys produce erythropoietin which allows the bone marrow to produce RBC
Therefore kidney failure means erythropoietin isn't being made and neither is RBCs

22

what are the consequences of chronic kidney failure

- inability to metabolize vitamin D, therefore low calcium
- elevated serum phosphate
- hyperthyroidism
- decreased bone health
- calcium and phosphate buildup in BVs
- hyperkalemia --> fatal arrhythmias

23

main treatment for chronic kidney failure

-prevent deterioration of renal function by hypertension
e.g. prescribe ACE inhibitor