Clinical Renal failure and tests Flashcards Preview

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Flashcards in Clinical Renal failure and tests Deck (13)
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1
Q

Blood tests for kidney failure

A

Creatinine and urea

Urea: higher when high protein intake; higher protein catobolism in infection; GI bleeding
Some is reabsorbed i.e is higher in dehydration

Creatinine: is proportional to muscle mass. Is NOT reabsorbed, so creatinine clearance is proportional to GFR

2
Q

Things about creatinine

A

After a meal of meat, creatinine will rise, and will falsely signify low GFR

3
Q

What will affect eGFR (better than just creatinine)

A

Weight (muscle)
Age
Gender
creatinine

4
Q

What are eGFR limitations?

A
  • Only useful if muscle mass is normal

- In steady state, not useful in acute kidney problems

5
Q

Acute kidney injury types

note it is sudden decline in GFR and usually reversible

A

Non renal 70% of cases

Pre renal; renal; post renal

6
Q

Pre renal AKI

Can get better or can get acute tubular necrosis

A

Causes are low BP; dehydration; sepsis; haemorrhage; cardiogenic shock; RA stenosis

Urine output is lower and will have high creatinine, hyperkalaemic (???)
high phophate and low calcium maybe

treatment (fix underlying problem)- rehydrate, treat bleeding, antibiotics, heart fixing

7
Q

Renal injury AKI

A

Acute tubular necrosis (80%)
mainly due to pre renal (low BP)
Also may be drugs (heroin, crack, contrasts) and toxins
OR rapid progressive glomerulonephritis

takes a while to heal, may need dialysis (NB dialysis does not heal the kidneys! keeps you alive by preventing hyperkalaemia)
maintain BP

Recovery- 95% get better; need IV fluids, as due to tubule damage can not concentrate urine so loads of urine

8
Q

RPGN

A

presents with blood or protein in urine and needs biopsy to diagnose

9
Q

Post renal AKI

A

Kidney stones, tumours, BPH, urinary retention

10
Q

CKD

A

Gradual decline in GFR and happens over years
Caused by: diabetes; glomerulonephritis, hypertension and more
glomerular scarring and slowly elevating creatinine

11
Q

What can uraemia cause? (note urea in blood as a result of reduced GFR)

A

Anorexia, nausea, vomiting, itchiness, SOB etc

12
Q

What are some other useful blood tests?

A

haemoglobin (due to low erythopoietin); increased serum phosphate; less active vitamin D (calcitriol) causing less calcium absorption in gut –> hyper parathyroidism

13
Q

How is bone affected/

A

Due to low calcium, and high phosphate in blood (low calcitriol also), high PTH meaning bone resoprtion. e bad. so fractures and extra osseus (like vascular) calcification