Theme 3 - Part IV Flashcards
Renal failure risks [7]
Extreme age Polypharmacy Specific disease state Longterm analgesia Transplant patient Drug therapy Imaging procedure
Imaging [3]
Gamma camera planar scintigraphy
Positron emission tomography
Single photon emission CT
Creatinine [2]
Breakdown of creatinine phosphate creatinine (muscle)
Filtered glomerulus (Secretion in PT)
Creatinine increased by [3]
Large muscle mass, diet intake and ketoacidosis
Analysis: methyldopa, dexamethasone, cephalosporins
Inhibit tubular secretion: cimetidine, trimethoprim, aspirin
Creatinine decreased by [2]
Reduced muscle mass, Cachexia and immobility
Pregnancy and severe liver disease
Analysis drugs
methyldopa, dexamethasone, cephalosporins
Drugs to inhibit tubular secretion
cimetidine, trimethoprim, aspirin
Urea [3]
Liver produces urea in the urea cycle as a waste product of protein digestion
Filtered at the glomerulus, secreted and reabsorbed in the tubule
Blood urea nitrogen:
Normal range: 2.5-7.5 mmol/L
Urea increased by [4]
High protein diet, GI bleed and muscle injury
Hypercatabolic conditions
Hypovolaemia
Drugs - tetracycline and glucocorticoid
Urea decreased by [4]
Malnutrition
Sickle cell anaemia
Liver disease
SIADH
INULIN
Freely filtered but not reabsorbed or secreted
Excretion rate = rate it was filtered.
Typical electrolyte
Freely filtered and partly or mostly reabsorbed
Excretion rate = filtration rate – reabsorbed.
Glucose and AA
Freely filtered but fully reabsorbed
No excretion (normally).
PAH
Freely filtered, not reabsorbed, fully secreted
Substance therefore rapidly and effectively cleared
Indicator of CKD [5]
Urinary albumin/protein excretion
Kidney injury molecule – 1 (KIM-1) (urine)
Interleukin (IL)-18 (urine)
Fatty-acid binding proteins (FABPs) (urine)
Neutrophil gelatinase-associated lipocalin (NGAL) (plasma & urine)
Cystatin C (plasma)
