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Flashcards in Introduction to Renal Disease Deck (15)
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1

Acute renal disease staging

*All focused on serum creatinine level and urine output*

Stage 1:
- 1.5-1.9 times increase in creatinine
or > 0.3 mg/dL
- urine output = <0.5 mL/h (for 6-12 hrs)


Stage 2:
- 2.0-2.9 times increase in creatinine
- urine output = <0.5 mL/h (for >12 hrs)

Stage 3:
- >3.0 times increase in creatinine
Or > 4.0 mg/dL total serum creatinine
- urine output = <0.3 mL/h (>24 hrs)
Or
Anuria for >12 hrs

2

Chronic renal disease staging

Based on GFR rates (mL/min/1.73)


stage 1: >90

Stage 2: 60-89

Stage 3a: 45-59

Stage 3b: 30-44

Stage 4: 15-29

Stage 5 (renal failure): <15 and/or requires dialysis daily

3

3 Renal disease categorization based on what is the underlying pathology

1) prerenal
- related to hypoperfusion

2) intrinsic/intracranial
- vascular/tubular/interstitial disease

3) postrenal
- urinary obstruction

4

Brown urine causes

Pathological:
- bile pigments and myoglobin in urine

Food and drug causes:
- favs beans
- levodopa, metronidazole, nitrofuratoin, antimalarial drugs

5

Black urine causes

Pathological:
- bile pigment build up
- methemoglobin in urine
- melanin in urine

Food and drug causes:
- levodopa, Methyldopa and senna use

6

Green/blue urine causes

Pathological:
- pseudomonas UTI
- build up of biliverdin

Food and drug causes:
- favs beans
- amitriptyline, cimetidine promethazine, methylene blue, indigo carmine use

7

Orange color urine

Pathological:
- bile pigments

Food and drug causes:
- pehnothiazines and pyridium

8

Red urine causes

Pathological:
- hematuria, hemoglobinuria, myoglobinuria, porphyria

Food and drug causes:
- beets, blackberries, rhubarb, phenolphthalein, rifampin

9

Yellow urine causes

Pathological:
- dehydrated urine

Food and drug causes:
- excess carrot consumption

10

What is normal urgent output in children infants and adults

Infant
- normal = 1.5-2 mL/hr
- oligouria = <1mL/hr for 6 hrs

Child
- normal = 1 mL/hr
- oligouria = <0.5 mL/hr

Adult
- normal = 0.5-1 mL/hr
- oligouria = <0.3-0.5 mL/hr

11

Dietary lifestyle changes in renal disease

Smoking cessation
- CKD Disease progression is hastened in patients who smoke

Dietary sodium reduction
- enhances affects of ACEIs and ARBs in order to lower albuminuria

Dietary protein restriction
- normal or increased protein consumption increases the rate of CKD progression

Weight management

Physical acitrivtiy increase
- lowers chance of CKD progression

12

What is nephrotic syndrome

A disorder that often occurs in severe kidney injury/disease in which the small vessels get destroyed in some way

Leads to the following complications:
- severe edema
- hypoalbuminemia
- proteinuria
- fatigue blood clot formation
- Hyperlipidemia (liver tries to compensate for poor albuminemia and also produces lots of triglycerides and cholesterol)
- malnutrition of especially vitamin D
- HTN

13

What is the normal BUN/creatinine ratio?

10:1

Lower:
- liver disease of some sort
- malnutrition

Increased:
- renal disease of some sort
- extreme dehydration

14

Sex and racial differences in GFR?

Black patients have high overall GFR

Females have higher overall GFR than males

15

Causes of false negatives for leukocyte esterase and nitrates

Leukocyte esterase
- elevated specific gravity
- glycosuria
- ketonuria
- proteinuria
- nitrofurantoin use
- tetracycline use
- high levels of vitamin C

Nitrites
- elevated urobillinogen levels
- urine pH < 6.0
- high levels of vitamin C