Paediatric Clinical Chemistry, Renal Physiology Flashcards Preview

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Flashcards in Paediatric Clinical Chemistry, Renal Physiology Deck (14)
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1

Common problems with low birth weight

-Respiratory distress syndrome
-Retinopathy of prematurity
-Intraventricular haemorrhage
-Patent ductus arteriosus
-Necrotizing enterocolitis - inflammation of bowel wall - necrosis and perforation

2

Paediatric Renal Function

-Functional maturity of glomerular filtration rate only by 2 years of age
-Less reabsorption than adult due to short proximal tubule
-Reduced concentrating ability due to short loops of Henle and distal collecting ducts
-Persistant sodium loss due to distal tubule being relatively aldosterone insensitive

3

Normal glomerular filtration rate

(GFR) = 120ml/hr

Age related decline of approx 1ml/hr/yr

4

Gold standard measure of GFR?

Inulin
- requires steady state infusion and difficult to assay so it is reserved for research purposes only

5

AKI - Pre-renal

Reduced renal perfusion with no structural abnormality

6

AKI - Renal

Vascular, glomerular, tubular or intestinal

7

AKI - Post-renal

Characterised by obstruction to urinary flow

8

Chronic Kidney Disease - Stage 1
- description
- GFR
- Prevalence (% of pop)

-Kidney Damage with normal GFR
-GFR>90ml/min
-3.3%

9

Chronic Kidney Disease - Stage 2
- description
- GFR
- Prevalence (% of pop)

-Mild decreased GFR
-60-89
-3%

10

Chronic Kidney Disease - Stage 3
- description
- GFR
- Prevalence (% of pop)

-Moderately decreased GFR
-30-59
-4.3%

11

Chronic Kidney Disease - Stage 4
- description
- GFR
- Prevalence (% of pop)

-Severely decreased GFR
-15-29
-0.2%

12

Chronic Kidney Disease - Stage 5
- description
- GFR
- Prevalence (% of pop)

-End stage kidney failure
-

13

Commonest causes of Chronic Kidney Disease?

-Diabetes
-Atherosclerotic renal disease
-Hypertension
-Chronic Glomerulonephritis
-Infective or obstructive uropathy
Polycystic kidney disease

14

Consequences of Chronic Kidney Disease?

1) Progressive failure or homeostatic function
-Acidosis
-Hyperkalaemia
2)Progressive Failure of hormonal function
-Anaemia
-Renal Bone Disease
3)Cardiovascular disease
-Vascular calcification
-Uraemic cardiomyopathy
4)Uraemia and Death