Overview of Renal Diseases Flashcards by Kisspeptin GnRH

What are the 7 functions of the kidney?

→ Excrete waste substances
→ Regulates minerals in extracellular fluid
→ Regulates water balance
→ RBC production
→ Blood pressure control
→ Vitamin D activation
→ acid base balance

How well did you know this?

Not at all

Perfectly

How much blood passes through the glomeruli per day?

→ 2000

How well did you know this?

Not at all

Perfectly

How much blood is filtered per day?

→ 200 L

How well did you know this?

Not at all

Perfectly

What tests are used to measure kidney function?

→ Blood tests
→ Creatinine
→ formulae
→ Urine output
→ Elimination of radioisotopes

How well did you know this?

Not at all

Perfectly

What is creatinine and where is it produced?

→ biomarker for filtration of the glomerulus

→ skeletal muslce

How well did you know this?

Not at all

Perfectly

What is asymptomatic proteinuria?

→ glomerular filter has become leaky

How well did you know this?

Not at all

Perfectly

What is nephritic syndrome?

→ Inflammatory condition in the glomerulus
→ RBC in urine
→ hypertensive
→ GFR falls

How well did you know this?

Not at all

Perfectly

What is haematuria?

→ blood in urine due to bleeding anywhere along the urinary tract

How well did you know this?

Not at all

Perfectly

What is chronic kidney disease?

→ Reduction in GFR that gets worse over time

How well did you know this?

Not at all

Perfectly

What does diabetes mellitus do to the kidney?

→ Chronic damage to kidney through high BP

How well did you know this?

Not at all

Perfectly

What are pre renal causes of kidney disease?

→ hypovolaemia
→ Perfusion decreases
→ Drugs

How well did you know this?

Not at all

Perfectly

How can hypovolaemia be caused?

→ Haemorrhage

→ Diarrhoea

How well did you know this?

Not at all

Perfectly

Why does perfusion decrease?

→ Septic shock

→ Cardiac failure

How well did you know this?

Not at all

Perfectly

How can drugs cause kidney disease?

→ Angiotensin converting inhibitors
→ NSAIDs
NSAIDs disrupt the compensatory vasodilation response of renal prostaglandins to vasoconstrictor hormones released by the body

How well did you know this?

Not at all

Perfectly

How are glomerular diseases diagnosed?

→ Urine analysis

→ measures blood and protein

How well did you know this?

Not at all

Perfectly

How is proteinuria quantified?

→ Urine albumin : creatinine ratio

→ Urine protein : creatinine ratio

How well did you know this?

Not at all

Perfectly

What does glomerular bleeding lead to?

→ Red cell casts in the urine

→ Red cells get stuck together and form the shape of the tubule

How well did you know this?

Not at all

Perfectly

How do dysmorphic erythrocytes form?

→ Red blood cells squeeze along the glomerular filter and become deformed

How well did you know this?

Not at all

Perfectly

What do you need to distinguish between in glomerular disease?

→ primary and secondary

How well did you know this?

Not at all

Perfectly

What is a post renal disease?

→ Acute kidney injury

How well did you know this?

Not at all

Perfectly

What happens in acute kidney injury?

Study These Flashcards

→ Fluid retention - lymphoedema leads to pulmonary oedema

→ Hyperkalaemia - high K+ leads to cardiac arrhythmias

What are the consequences of acute kidney injury?

Study These Flashcards

→ Impact on outcome
- hospital mortality
→ Resources
- length of stay in hospital
- referrals, tests and treatments
→ Patient morbidity
- Acute complications
- dysfunction of other organs
- risk of CKD

What are the long term sequelae of acute kidney disease?

Study These Flashcards

→ CKD
→ ESRF (end stage renal failure)
→ death

How is AKI measured?

Study These Flashcards

changes in creatinine

If there is a problem with blood going into the kidney what is this called?

→ pre renal

if there is a problem with the kidney what is this called?

→ renal

If there is a problem with urine getting out what is this called?

→ post renal

What are intrinsic renal causes?

→ Glomerular - glomerulonephritis - systemic disease → Tubular - acute tubular necrosis → Vascular and interstitial →Interstitial Interstitial nephritis

What are the 3 kidney compartments?

→ vascular → tubulointerstitial → glomerular

What are 3 tubulointerstitial diseases?

→ acute tubular injury → acute tubulointerstitial nephritis → chronic tubulointerstitial nephritis

What does it mean if the bleeding is in the urinary tract?

→ a symptom of cancer

What are the two ways that the glomerulus can fail?

→ Filter things it shouldn't | →Not filter things it needs to filter (reduced GFR)

What is nephrotic syndrome?

→ Heavy proteinuria → hypoalbuminaemia → Oedema (result of hypoalbuminaemia) → frothy urine

What are signs of nephritic syndrome?

→ Both filter failures → Abrupt onset → reduced GFR →blood and protein in urine

What are asymptomatic urine abnormalities and what is important in it?

→ blood or protein in urine | → IgA nephropathy is important

What is rapidly progressive glomerular nephritis?

→ both modes of filter failure | → Weeks or months

What is a cause of nephritic syndrome?

→ Post-streptococcal GN

What are three causes of rapidly progressive GN?

→ Goodpasture disease | → ANCA (small vessel anti neutrophil cytoplasm antibody)

What is the first stage in AKI management?

→ Correct pre-renal factors | → Relieve obstruction

What is the second stage in AKI management?

→ Maintain fluid and electrolyte balance → Nutrition → Gastric protection

What are the effects that indicate dialysis may be needed?

→ Oedema (pulmonary) | → Hyperkalaemia

By what amount is your risk of cardiovascular mortality increased by when on dialysis?

→ 300 -400 x

What is CKD a marker of?

→ cardiovascular risk

How is CKD treated?

→ Treating endocrine issues → Ca2+, PO4, Vitamin D, PO4 binders, alfacalcidol → IV Fe and erythropoeitin

What are the three options for end stage renal failure?

→ Dialysis → Transplantation → Conservative management

What are the two forms of dialysis?

→ Haemodialysis | → Peritoneal fluid

What are 2 types of donors?

→ brain death | → cardiac death

What should be considered when deciding what time to start RRT?

Avoids: metabolic abnormalities and problems of volume overload Exposes patient to potential of: Venous thrombosis →Bacteraemia →Haemorrhage from anticoagulants

What is obstructive uropathy?

→Prostatic obstruction causes 25% of AKI →Single remaining kidneys at high risk →Can still produce significant amounts of urine →Delay in correction (catheter or nephrostomy) compromises renal function permanently

Indications for acute dialysis...

``` →Hyperkalaemia refractory to medical therapy K+ > 6.5 with ECG changes →Severe Acidosis pH < 7.25, HCO3 <15 →Fluid overload despite high-dose furosemide appropriate →Symptomatic uraemia: urea > 35 Pericarditis, encephalopathy ```

Describe peritoneal dialysis

→Peritoneum used as the membrane Solute and water exchange between peritoneal capillary blood and dialysate fluid →Membrane= vascular wall, interstitium, mesothelium and adjacent fluid films →Small molecules transfer by diffusion Fluid movement determined by osmosis →Dialysate dextrose concentration Solvent drag for middle sized molecule

Describe haemodialysis

Blood passes down one side of a highly permeable membrane →Water and solutes pass across the membrane →Solutes up to 20,000 daltons Drugs & electrolytes →Infuse replacement solution with physiologic concentrations of electrolytes

Overview of Renal Diseases Flashcards

(52 cards)