Renal failure Flashcards
(17 cards)
What happens when the kidneys fail
Loss of excretory function
Loss of homeostatic function
Loss of endocrine function
Abnormality of glucose homeostasis
What are the consequences of a loss of excretory function
Accumulation of waste products
What are the consequences of a loss of homeostatic function
Disturbance of electrolyte balance
Loss of acid-base control
Inability to control volume homeostasis
What are the consequences of a loss of endocrine function
Loss of erythropoietin production
Failure to produces 1-alpha-hydroxylase -> no vit D
What are the signs and symptoms of renal failure
Pale, Hands cold Poor skin turgor Pulse rate low - 50bpm Blood pressure low - 67/35 Jugular Venous Pulse not visible Tachypnoeic Clear lungs on auscultation Extreme lethargy Weakness Anorexia
What can be used to diagnose renal failure
Elevated plasma urea and creatinine
What might be discovered on a blood test for those in renal failure
Hyperkalaemia
Hyponatraemia
Metabolic acidosis
Anaemia
What is a difference between acute and chronic renal failure
Renal size is unchanged in acute
Ultrasound for chronic will reveal shrunken kidneys
What causes lethargy
Accumulation of nitrogenous waste products, hormones, peptides Acidosis Low blood pressure Anaemia Chronic neuropathy
What are the symptoms of chronic kidney disease
Hypertension
Oedema
Pulmonary oedema
What are the causes of chronic kidney disease
Inability to increase sodium reabsorption
Osmotic diuresis
High loss of salt and water
What is the cardiovascular effect on kidney disease
Hyperkalaemia causes arrhythmias
Increased potassium causes depolarisation and sodium channel inactivation
Impairs conduction and excitability -> heart block
What is the major outcome for a patient with chronic kidney disease
Cardiovascular disease Hypertension Secondary cardiac effects Endothelial effects Lipid abnormalities
What is the disadvantage of using urea to assess GFR
Poor indicator, confounded by diet, catabolic state, GI bleeding, drugs, liver function
What is the disadvantage of using creatinine to assess GFR
Affected by muscle mass, age, race, sex
What is the disadvantage of using creatinine clearance to assess GFR
Difficult for elderly patients to collect an accurate sample
Overestimates GFR at low GFR
Describe radionuclide studies
Reliable but expensive
