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Flashcards in Renal Deck (32)
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what does protein in the urine suggest

glomerular filtration failure - should only filter fluid and electrolytes


how is renal function measured

serum urea or serum creatinine


what is seen in renal failure

excretory failure, imbalance of electrolytes, endocrine failure - erythropoeitin, ca metabolism, renin secretion


what is the difference between acute and chronic renal failure

acute - happens suddenly, over hours or days
chronic - gradually lost, over years


what are the 3 causes of renal failure

pre-renal - hypoperfusion of kidney, loss of blood
intra renal - toxins or drugs
post - renal - blockage of urinary duct


what is rhambdomyolysis

large injury damage to muscle, many proteins in blood, blocks the glomerulus, cannot get filtration


what is normally associated with acute renal failure

sudden loss of function - not filtrating anything - build up of fluid - oedema, pulmonary oedema
then get filtration function back - polyuria - before concentrating comes back


how is the cardiac rhythmn affected in acute renal failure

hyperkaelaemia - high potassium and sodium as there is no filtration or electrolyte balance - can alter neuronal activation


what is normally the cause of acute renal failure

pre-renal - infection or injury, hypoperfusion


what is the cause of chronic renal failure

primary - glomerulonephritis, polycystic kidney disease
secondary - diabetes, hypertension


what is glomerulonephritis

normally in children, autoimmune disease attacking glomerulus, proteins leaking through, decrease in plasma proteins - reduced oncotic pressure so increase in oedema


what drugs should be avoided in renal disease

NSAID's - reduce glomerular blood flow and renin secretion
nephrotoxic drugs - cyclosporin


what are the signs and symptoms of chronic renal disease

symptoms - normally not many, polyuria, nocturia, weak and tired
signs - anaemia, hypertension, renal bone disease


how is chronic renal disease managed

treat infections
remove obstruction - cysts, atheroma, malignancy
reduce hypertension
treat deficiencies - anaemia, calcium and vitamin d
treat diabetes
restrict fluid retention - reduce fluid intake, control sodiuma and potassium intake


what functions of the kidney does renal replacement aim to replace

fluid filtration - excretory function
electrolyte balance
acid base balance


what is contained in the dialysing solution

concentration of electrolytes and fluid we want in our blood to be, allows for passive diffusion of contents from our blood into solution and vice versa


what is involved in haemodialysis

taking blood out your body, anticoagulating it with heparin, then passing it through dialysing solution, before it coming back into your body


why does a patient need to be prepared for haemodialysis

need to prepare an arteriovenous fistula - allows to take blood out of artery and pump it back into vein


what is the dialyser permeable to

hollow tubes, surrounded by dialysing solution, permeable to electrolytes but impermeable to cells and proteins


how is haemodialysis restricting

patient needs to be hooked up every couple days, means they cant go on holiday, also have days they feel good if just had dialysis, feel bad if a day inbetween, restricts what you can eat and drink


how does peritoneal dialysis work

putting fluid in peritoneal sac - completely closed off, small vessels can set up concentration gradient between blood and fluid. can then drain back out of peritoneum


what benefits does peritoneal dialysis have

patient has more control, can do it themselves wherever, not as many ups and downs with feeling if getting it every day, more like real function


what implications does renal treatment have on dentistry

if on haemodialysis - should get treatment the same day as dialysis, feel better
if on peritoneal - doesnt matter as much
if renal transplant - need to be aware of immunosupressants, may require steroid prophylaxis


how do urinary tract infection manifest

perineal bacteria on tract, reduced urinating, normally this washes it away but allows them to colonise. causes inflammation of epithelium


what symptoms are associated with UTI

pain on urinating, dysuria, peeing frequently but little coming out, cloudy urine


how is a UTI diagnosed

mid stream sample - urine should be sterile, the first bit may be contaminated as it washes away, but the middle should be sterile. if sample has cells, proteins or bacteria - infected


how is a UTI treated

normally just increase fluid intake, will wash more away. rarely need antibiotics unless in kidneys


what is renal canaliculi

stones produced in kidney, fine here but then go down ureter, cannot pass them. very painful need to wait for them to pass. can use lithotripsy - ultrasound energy to break them up and allow them to pass


what is prostatitis

inflammation of prostate - enlarges and pushes on urinary tract, restricts space. can be painful to pass urine


what is benign hyperplastic prostate

increased size of prostate gland, reduces space for urethra, pain on peeing or peeing a lot, reduced emptying. happens over several years and is very common. can be put on adreno blocking drugs or surgery