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MNT II > Renal > Flashcards

Flashcards in Renal Deck (21):
1

Regulatory Function

Control composition and volume of blood.
Maintain stable concentrations of inorganic anions such as Na, K, and Ca.
Maintain acid base balance.

2

Excretory Function

Produce urine.
Remove metabolic waste including nitrogenous waste.

3

Hormone Function

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).

4

Metabolic Function

Gluconeogenesis.
Metabolize drugs and endogenous substances like insulin.

5

Nephron Functions

Filtration- glomeruli ultrafiltrate of the plasma.
Reabsorption- tubules selectively reabsorb substances from the ultrafiltrate.
Secretion- tubules secret substances into the urine.

6

Filtration

Glomeruli generate ultrafiltrate of the plasma.

7

Reabsorption

Tubules selectively reabsorb substances from the ultrafiltrate.

8

Secretion

Tubules secrete substances into the urine.

9

Ultrafiltration

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

10

Volume of Ultrafiltrate

135-180 liters per day

11

Water Reabsorption

99% is reabsorbed

12

Urine Excreted

1-1.5 liters per day is excreted

13

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.

14

Chronic Kidney Disease (CKD)

Reduced kidney function and/or kidney damage.

15

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.

16

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.

17

eGFR

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.

18

Kidney Failure

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.

19

Elevated UACR

Associated with risk of renal events; lowering UACR may lower risk of progression.

20

Leading causes of kidney failure in the US...

Diabetes and hypertension.

21

Energy Needs in CKD

Not higher.
Individualized.
Need 23-35 kcal/kg to maintain nutritional status.