Renal Disease (IC)

Question 1

How many nephrons (working parts) are in each kidney?

Answer 1

About one million

Question 2

What is inside a nephron?

Answer 2

A glomerulus (filtering unit) inside of which is a cluster of capillaries

Question 3

How much ultrafiltrate is processed in the kidneys each day?

Answer 3

180L

Question 4

Where does liquid waste travel from the kidneys?

Answer 4

To the bladder via ureters

Question 5

How much liquid waste is excreted per day?

Answer 5

1.5L

Question 6

What are the waste materials in urine?

Answer 6

Protein waste (urea, uric acid, creatinine, ammonia, and sulfates), excess water and nutrients, dead renal cells, and toxins

Question 7

Oliguria eventually leads to what?

Answer 7

Renal failure

Question 8

What urinary output is considered oliguric?

Answer 8

Under 500mL per day

Question 9

What hormones do the kidneys produce?

Answer 9

The final form of vitamin D (calcitriol) and erythropoietin

Question 10

What are some causes of kidney disorders?

Answer 10

Infection, diabetes, HTN, cysts, renal stones, or trauma

Question 11

What are the symptoms of uremia?

Answer 11

Nausea, headache, convulsions, and coma

Question 12

What are nephritis and glomerulonephritis?

Answer 12

General terms for renal inflammation

Question 13

What is nephrosclerosis?

Answer 13

The hardening of renal arteries caused by arteriosclerosis and HTN, occurring in older people and diabetics

Question 14

What is polycystic kidney disease?

Answer 14

A genetic condition which goes unnoticed until renal failure at roughly age fifty

Question 15

What is nephrolithiasis?

Answer 15

Kidney stones– causes hematuria, infection, obstruction, and pain

Question 16

What is the goal of dietary treatment for renal disease?

Answer 16

To decrease waste in the blood

Question 17

Why should weight loss be prevented for renal clients?

Answer 17

Tissue is metabolized and circulated through the blood

Question 18

What is often restricted in the diets of renal clients?

Answer 18

Protein, sodium, and often phosphorus and potassium

Question 19

During stage 3-4 of renal disease, what may protein intake equal?

Answer 19

40g (no more than 3oz protein and 1/2c of milk)

Question 20

What is the typical exchange diet for a client with stage 3-4 renal disease?

Answer 20

2 servings of 1/2c vegetables, 7 servings of grains, 5 servings of 1/2c fruit, and no more than 3oz protein and 1/2c milk

Question 21

What types of fruits and vegetables should be consumed during renal treatment?

Answer 21

Low and moderate potassium

Question 22

What are fluids and sodium limited during renal treatment?

Answer 22

Decrease edema and prevent hypertension and congestive heart failure

Question 23

What nutrients are increased during renal treatment?

Answer 23

Calcium and vitamin D; sugar and fat for calories

Question 24

Why is phosphorus decreased during renal treatment?

Answer 24

To prevent osteomalacia because it is often retained in renal clients

Question 25

What proportion of diabetics develop kidney disease?

Answer 25

1/3 (30% T1D and 10-40% T2D develop ESRD)

Question 26

Why is potassium restricted for renal clients?

Answer 26

Hyperkalemia tends to occur in ESRD, leading to MI (no salt subtitutes!)

Question 27

What nutrients should be supplemented for renal disease?

Answer 27

vitamins B, C, and D, and iron to prevent anemia

Question 28

Why should vitamin A not be given to renal clients?

Answer 28

In uremia, blood levels are increased already

Question 29

How does hemodialysis work?

Answer 29

Using a permanent fistula near the wrist. 3 times a week for 3-5 hours

Question 30

How does a peritoneal dialysis work?

Answer 30

Using the peritoneal cavity. 3 times a week for 10-12 hours (less efficient than hemodialysis)

Question 31

How often is Continuous Ambulatory Peritoneal Dialysis (CAPD)?

Answer 31

Occurring 4-5x daily; 24 hour treatment

Question 32

What are some complications associated with Continuous Ambulatory Peritoneal Dialysis (CAPD)?

Answer 32

Peritonitis, hypotension, and weight gain

Question 33

What is the protein requirement during dialysis?

Answer 33

1.2g protein per kg of body weight

Question 34

What percent of protein should be high biological value (HBV) from animal products for dialysis clients?

Answer 34

50%

Question 35

How much potassium do healthy people ingest?

Answer 35

2,000-6,000mg

Question 36

How much potassium should be ingested during renal failure (NOT ESRD)?

Answer 36

2,000-4,000mg

Question 37

How much potassium should be ingested during ESRD?

Answer 37

1,500-2,500mg

Question 38

Why is milk restricted to 1/2c or not allowed on renal diets?

Answer 38

High in potassium and methionine

Question 39

What is the 80-3-3 diet?

Answer 39

For dialysis patients; 80g protein, 3g sodium, and 3g potassium

Question 40

How many portions of protein are used on an 80-3-3 diet?

Answer 40

8 portions

Question 41

How many portions of fat are used on an 80-3-3 diet?

Answer 41

Unrestricted

Question 42

Which vitamins and minerals should be supplemented during dialysis?

Answer 42

Vitamins C + B to the DRI; Iron and D when blood levels are low

Question 43

Which minerals may be given after a kidney transplant?

Answer 43

Calcium and phosphorus to undo bone loss

Question 44

What percent of all renal stones are calcium oxalate?

Answer 44

80%

Question 45

What are the risk factors for calcium oxalate stones?

Answer 45

Excessive animal protein or oxalates (in beets, bran, chocolate, tea, and strawberries); deficiencies of vitamin B6, thiamine, and magnesium

Question 46

What is the treatment for uric acid stones?

Answer 46

Reduce purines (end products of nucleoprotein metabolism found in meat, alcohol, and broth) in the diet; medicate to reduce uric acid formation

Question 47

What complications are associated with uric acid stones?

Answer 47

Gout, diarrhea, and malignant disease

Question 48

How do cystine stones form?

Answer 48

From hereditary disorder; made up of amino acid

Question 49

What is the dietary treatment for cystine stones?

Answer 49

Increase fluids and follow an alkaline-ash diet

Question 50

What are struvite stones?

Answer 50

Magnesium ammonium phosphate buildup post UTI (called "infection stones")

Question 51

What is the dietary treatment for struvite stones?

Answer 51

Restrict phosphorus