Flashcards in Renal Deck (21):
Control composition and volume of blood.
Maintain stable concentrations of inorganic anions such as Na, K, and Ca.
Maintain acid base balance.
Remove metabolic waste including nitrogenous waste.
Produce renin for blood pressure control.
Produce erythropoietin which stimulates marrow production of red blood cells.
Activates 25(OH) to 1,25(OH)2D (active vitamin D).
Metabolize drugs and endogenous substances like insulin.
Filtration- glomeruli ultrafiltrate of the plasma.
Reabsorption- tubules selectively reabsorb substances from the ultrafiltrate.
Secretion- tubules secret substances into the urine.
Glomeruli generate ultrafiltrate of the plasma.
Tubules selectively reabsorb substances from the ultrafiltrate.
Tubules secrete substances into the urine.
Main function of the glomeruli. Filtration is based on size and charge:
Small solutes cross readily
Larger substances are generally restricted
Negatively charged molecules are restricted
Volume of Ultrafiltrate
135-180 liters per day
99% is reabsorbed
1-1.5 liters per day is excreted
Urine Albumin-to-Creatinine Ratio (UACR)
An elevated UACR is used to identify damages kidneys. Used for screening, diagnosing, and treating CKD. It is a standard of diabetes care. Tool for pt education and self-management.
Chronic Kidney Disease (CKD)
Reduced kidney function and/or kidney damage.
CKD Kidney Function
glomerular filtration rate (GFR) <60 mL/min/1.73m2 for greater than or equal to 3 months with or without kidney damage.
CKD Kidney Damage
Greater than or equal to 3 months, with or without decreased GFR, manifested by either pathological abnormalities or markers of kidney damage i.e. albuminuria with UACR >30 mg/g.
Is used to assess and monitor kidney function. The eGFR provides an estimate of how much blood is filtered by the kidneys each minute. The formula used to estimate GFR uses serum creatinine, age, gender, and race.
eGFR <15. Kidneys cannot maintain homeostasis. Kidney failure is associated with fluid, electrolyte, and hormonal imbalances and metabolic abnormalities. ESRD means the pt is on dialysis or has a kidney transplant.
Associated with risk of renal events; lowering UACR may lower risk of progression.
Leading causes of kidney failure in the US...
Diabetes and hypertension.