renal system (not comprehensive) Flashcards
(49 cards)
what is the main function of the kidneys
- water and electrolyte homeostasis
- acid base balance
- erythropeitin
- renin
- activate vitamin D
- excretory function
if you find ___ in pee, your kidneys are not working. Why?
rbc, blood, proteins, immune cells
^^
it means your kidneys are not working. those by right should not be able to filter across glomerulus, and or should not be rebsorbed
healthy gfr and unhealthy gfr rate
healthy above 90
unhealthy below 60
Difference between acute and chronic renal failure
- Acute rapid over hours or days, reversible with time
- Chronic gradual loss of function over years , irreversible
what causes pre, renal, post failure
pre renal - problems with circulation of blood into the kidneys
renal - problems with kidney itself
post renal - problems with outflow
what causes acute pre renal renal failure
hypovolaemia, diarrhoea, dehydration
something that causes a sudden large drop in BP, large decrease in GFR
what causes intrarenal renal failure
- damage to kidneys itself
- chronic disease
- inflammation/ infections eg glomerular nephritis
- drug damage
- trauma
what are some examples of outflow obstruction
UTI
UT obstruction
- tumours
- stones (renal calculi)
- BPH benign prostate hypertrophy
UTmalignancy
how to diagnose renal failure
eGFR
should there be creatinine in blood?
no, creatinine should not be getting reabsorbed
serum creatinine >200umol/L means what
acute renal failure
what can hyperkalaemia cause?
cardiac arrest
why is there ankle and pulmonary odema in ACUTE renal failure?
there is NO urination at first, leads to volume overload, fluid pools in lungs and ankles
what happens after zero urination in acute renal failure
polyuria ie pee alot
this is because filtration function has returned but concentration ability has not returned
main cause of chronic kidney failure
hypertension
diabetes
other than hypertension and diabetes, what other causes of kidney failure is there
nephrotoxic drugs
NSAIDs
glomerulonephritis
vasculitis
aorta or renal artery disease
polycystic kidney disease
Diagnosis of chronic kidney disease
eGFR – less than 90ml/min = normal or minimal damage
less than 60ml/min = irreversible damage and decreased function
less than 15ml/min = end stage renal disease
creatinine 800-1000umol/L = end stage renal disease
Treatment of chronic renal failure
- manging diabetes and hypertension
- manage vasculitic diseases
- dialysis
- restrict fluid intake, salt, potassium, proteins
- eliminate nephrotoxic drugs, NSAIDs
- end stage renal disease -> renal transplant
- correct anaemia deficiency by blood transfusion
- correct calcium deficiency
- remove renal stones
- treat any chronic kidney inflammation
what to take note when prescribing medication
- avoid NSAIDs
- reduce dosage
- ## check all drugs with renal physician
oral manifestations of renal failure
growth may be slower
- oral ulceration
- painful mucosa and tongue
- white patches aka uremic stomatitis
- oral opportunistic infections
- dry mouth
- taste disturbances
- bleeding tendencies
- renal osteodystrophy -> loss of lamina dura
- bony radiolucency
what can chronic renal failure lead to
- less vit D activated -> hypocalcaemia -> increased bone resorption -> osteodystrophy
- falling GFR -> increased renin -> hypertension
- less erythropoietin -> less rbc -> anaemia
- weakness
- nausea
- polyuria
- renal bone diseases
o osteodystrophy
o osteomalacia
RENAL REPLACEMENT THERAPY
- transplant
- dialysis
dialysis solution contains
o low conc of solutes that you want out of the blood
o high conc of solutes that you want in blood
what sort of diffusion in dialysis
- passive diffusion
