GPT 2.08 Notes Flashcards
(35 cards)
What are the main roles of the kidney in homeostasis?
Regulates salt and water balance, acid-base balance, excretes waste and toxins
How does the kidney regulate salt and water balance?
Via Na+ reabsorption, water reabsorption (ADH), and aldosterone
How does the kidney maintain acid-base balance?
Excretes H+, reabsorbs HCO3−, generates new bicarbonate
What are normal arterial blood gas values?
pH: 7.35–7.45, PaCO2: 4.7–6.0 kPa, HCO3−: 22–28 mmol/L
What causes a metabolic acidosis on ABG?
Low pH, low HCO3−, compensatory low PaCO2
What are examples of kidney excreted waste products?
Urea, creatinine, uric acid, drugs, ammonia
What are the endocrine roles of the kidney?
Erythropoietin, renin, activation of vitamin D (calcitriol)
What are key tests for assessing renal function?
Serum creatinine, urea, eGFR, urinalysis, imaging
How is pre-renal AKI distinguished?
Low urine sodium, high urea:creatinine ratio, response to fluids
What causes pre-renal AKI?
Hypovolemia, hypotension, heart failure, renal artery stenosis
What causes intrinsic (renal) AKI?
Glomerulonephritis, acute tubular necrosis, interstitial nephritis
What causes post-renal AKI?
Obstruction: stones, BPH, tumors, urethral stricture
What is the initial management of AKI?
Identify and treat cause, stop nephrotoxins, fluid balance, monitor electrolytes
What are key causes of chronic kidney disease (CKD)?
Diabetes, hypertension, glomerulonephritis, infection, stones, obstruction
What are the stages of CKD based on eGFR?
Stage 1: >90; Stage 2: 60–89; Stage 3: 30–59; Stage 4: 15–29; Stage 5: <15 (end-stage)
What is the pathophysiology of CKD?
Progressive nephron loss → hyperfiltration, fibrosis, reduced clearance of waste
How do drugs affect renal function?
Some are nephrotoxic (e.g. NSAIDs, aminoglycosides), others depend on renal clearance
Why adjust drug dosing in CKD?
Reduced clearance → accumulation and toxicity; pharmacokinetics and dynamics altered
What is the role of ACE inhibitors in CKD?
Slow progression by reducing intraglomerular pressure and proteinuria
What are non-mechanical strategies for CKD management?
Blood pressure control, glycemic control, dietary modification, avoid nephrotoxins
What are the principles of dialysis?
Removes waste, balances fluids/electrolytes, used when GFR is very low or symptomatic uremia
When is renal transplantation considered?
In end-stage renal failure, as definitive treatment
What is the relationship between CKD and cardiovascular disease?
CKD increases risk of atherosclerosis, heart failure, arrhythmias, due to shared risk factors and uremia
What controls micturition?
Pontine micturition center, spinal cord (S2–S4), detrusor muscle, internal/external sphincters
