Renal Flashcards
(28 cards)
Loop of henle
U shaped portion of renal tubule
Where loop diuretics works
Descending loop
Removes water from filtrate
Ascending loop
Removes na and cl from filtrate, helps maintain osmolarity
Distal convoluted tubule
Removes na and h2o from filtrate
Regulatory functions of kidney
Control fluid and electrolyte and acid based balance
Hormonal functions of kidney
Control blood pressure, RBC formation , and vitamin d activation
3 steps to formation of urine
Glomerular filtration
Tubular reabsorption
Tubular secretion
Glomerular filtration
Blood flows into glomerulus from afferent arteriole
Filtration occurs
Filtered fluid enters renal tubules
Regulation of electrolyte excretion
K: kidneys excrete more than 90% of total daily intake to maintain normal level
Most abundant intercellular ion
Hyperkalemia most life threatening effect of renal failure
Leads to cardiac dysthymia
Acid based balance
2 major functions of kidneys to maintain acid based balance
Kidneys reabsorb and return any HCO3 from urinary filtrate
Excrete acid in the urine
Helps maintain normal ph
Prostaglandin
Hormone
Produced in kidney and other tissues
Help regulate glomerular filtration and renin production
Increase sodium and water retention
Proximal convoluted tubule
Unit of nephron that receives filtrate from glomerular capsules , reabsorbs water and electrolytes
Benign prostatic hyperplasia
Enlarged prostate
Occurs in proximately 1/2 of men over 50 and older
90% of men 80 and older
Obstructs outflow of urine due to bladder outlet obstruction
Cause unknown
Causes incomplete emptying of bladder and urinary retention
Uti result of urinary stasis
Bph manifestations
Difficulty starting stream of urine and continuing urination
Interruption of stream
Decrease in caliber and force of stream
Sensation of incomplete bladder emptying
Dribbling , frequency, urgency , nocturia
Complications : acute urinary retention, uti, sepsis, calculi, renal failure caused by hydronephrosis, pyelonephritis
Urethral catheter
And wine catheter it’s the most common room it’s a close drain system
Triple lumen or 3 way catheter used after Turp to allow for Cbi
ACute kidney injury
Reversible syndrome that results in decreased glomerular filtration rate and oliguria
Azotemia
Uremia
Accumulation of metabolic waste in the blood
When Azotemia becomes symptomatic
Aki
Decreased perfusion of kidneys, damage to kidney tissue, and obstruction
Hypotension, hypovolemia, decreased cardiac output, chf , kidney or intimacy Tract obstruction, obstruction of renal arteries or veins
Pre renal
Outside the kidney renal bloodflow, leading to ischemia in the nephrons and leads to a decrease in renal perfusion
Account for 60-70% cases of arf
Hypovolemia , heart failure primary causes
Intra renal
Actual damage to renal tissue resulting in malfunction of glomeruli or renal tubules
Prolonged ischemia, nephrotoxins (NSAIDs) renal artery or vein stenosis, acute glomerulonephritis
Give dopamine low dose to decrease renal perfusion
Can cause pyelonephritis
Post renal
Caused by actual obstruction of urinary flow
Account for 1-10% cases
Elderly
Bph, renal calicui, trauma cancers in urinary tract
Urine backs into renal pelvis
Need to relieve obstruction
Therapy for bph
5 A reductase inhibitor
Alpha 1 selective blocking agents
5 a reductase inhibitor
Shrink prostate gland, improve urine flow , prevent conversion of testosterone to dihydrotestosterone leading to decrease in size of prostate
Finasteride (proscar)
Dutasteride (avodart)
Proscar
Decrease in sexual activity and erectile dysfunction
Can take up to 6 months to work
Don’t handle if pregnant
