End-Stage Renal Disease Flashcards
(30 cards)
What is End-stage renal disease (Chronic Renal Failure)?
kidney failure so severe it requires dialysis or renal transplant. Massive loss of renal function leading to characteristic symptoms and labs (uremia)
What are the most common causes of End-stage Renal Disease?
Diabetes and Hypertension
What is Uremia defined as?
Metabolic Acidosis
Fluid Overload
Encephalopathy
Hyperkalemia
Pericarditis
Conditions for which dialysis is the treatment
What are common clinical manifestations of Renal Failure?
Anemia
Hypocalcemia
Osteodystrophy
Bleeding
Infection
Pruritus
Hyperphosphatemia
Hypermagnesemia
Accelerated atherosclerosis and hypertension
Endocrinopathies
How does renal failure lead to Anemia?
Loss of EPO leads to normochromic, normocytic anemia
How does renal failure lead to Hypocalcemia?
The kidney normally activates 25-hydroxy-vit-D to 1,25-Dihydroxy-vitamin-D: without the activation the body will not absorb enough Ca from the gut
How does renal failure lead to osteodystrophy?
Low Ca leads to secondary hyperparathyroidism which removes Ca from the bones making them soft and weak
How does renal failure lead to bleeding?
PLTs will not work normally in a uremic environment: they will not degranulate and will not work
How does renal failure lead to infection?
Neutrophils will not be able to degranulate and combat infection
How does renal failure lead to Pruritus?
Urea accumulates in skin
How does Renal failure lead to Hyperphosphatemia?
High Parathyroid levels release Phosphate from bones but the body is unable to excrete it
How does Renal failure lead to Hypermagnesemia?
Loss of Excretory ability
How does renal failure lead to accelerated atherosclerosis and Hypertension?
1 Cause of death in patients on dialysis
lymphocytes help to keep the arteries clear of lipid accumulation: uremia causes WBC to not function normally
How does renal failure lead to Endicrionpathy?
F: anovulatory
M: low Testosterone, Erectile Dysfunction
Insulin increases but so does insulin resistance
How is Anemia treated?
EPO replacement and Fe supplements
How is Hypocalcemia and Osteomalacia Treated?
Replacement of Vit D and Ca
How is Bleeding treated?
DDAVP: increase PLT function: only given if bleeding
How is Pruritus treated?
Dialysis and UV light
How is Hyperphosphatemia treated?
Oral binders
How is Hypermagnesemia treated?
Restriction of High-Mg foods, laxatives and antacids
How is Atherosclerosis treated?
Dialysis
How is Endocrinopathy treated?
Dialysis, Estrogen and Testosterone replacment
What are common drugs used to treat Hyperphosphatemia?
Sevelamer
Lanthanum
Calcium Acetate
Calcium carbonate
Cinacalcet and Etelcalcetide: inhibit PTH and mimic Ca on Parathyroid gland
What are common complications of ESRD?
calciphylaxis and Nephrogenic Systemic fibrosis
