Medications affecting the kidneys Flashcards
(19 cards)
Medication affecting the kidney what can target
Elimination
Effect on BP
Effect on fluid status
Electrolytes
When stop methotrexate with eGFR
- Review if eGFR <45
- Stop if <30
- Prescribe with caution if rapid change in GFR
Why cant take sulfonylureas with kidney disease
Increased half life as not cleared -> hypoglycaemia
Trimethoprim and kindneys
- Increase risk hyperkalemia
- Cretinine serum increase (increased tubular secretion)
- May → false positive AKI diagnosis due to raised creatinine levels
Solutes absorbed by kdineys
- Sodium
- Potassium
- Bicarbonate
- Chloride
- Amino acids
Diseases casing CKD
- Diabetes
- HPTN
- Vascular disease
- MI, CVD, PVD
- BPH
- Recurrent UTI - chronic pyelobephritis
- Rexurrent kidney stones - nephrocalcinosis
Diseases causing AKI
- SLE
- Vasculitis
- Infections - HepB/C, HIV
- Myeloma
Causes of oliguria <300ml a dya
- Nephirtic syndrome
- Acute renal failure
- Chronic end satge renal fialure
ANuria causes
- Conplete obstruction
- Vascular catastrophe
- Acute cortical necrosis
Causes of polyuria
- Diuretics
- Reduced ADH secretion
- Cranial diabetes insipidus
- Aclohol
- Insensitivity to ADH
- Nephrogenic diabetes insipidus
- Psychogenic polydipsia
- Atrial naturitic peptide (ANP) release
- Cardiac arrhytmias
- Cardiac failure
- Osmotic diuresis
- Hyperglycaemia
- Hypercalcuria
- CKD
Causes of nocturia
- CKD
- Conditions with osmotic agent in urine eg glucose in DM
- Prostatic disease
What colour is wee in nephritic sundrome
Cola
What does tea coloured urine occur in
Myoglobinuria - secondary to rhabdomyolysis
What does hyperphosphatemia cause
- itchiness, lethargy
What does if HPTN, anaemia, uraemia or hyperphosphatemia suggest
Kidney cant perform basic tasks
How do nsaids affect the kidneyd
- Impair renal autoregulation bu inhibiting prostaglandin mediated vasodialation of afferent arteriole
- Reduced blood supply
What is the danger of using ACEis/ARBs and NSAIDs
NSAIDs reduce Q in afferent glomerulus
ACEis/ARBs reduce Q ine fferent
-> reduced flow in and out of kidneys
What does metformin increase the risk of in renal imparment
Lactic acidosis
What eGFR stop metformin iwth
<45 review
<30 STOP
Caustion if rapid eGFR cahgne
