Urinary System 8 - What happens when the kidneys stop working? Flashcards Preview

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Flashcards in Urinary System 8 - What happens when the kidneys stop working? Deck (13)
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1
Q

What happens when the kidneys stop working?

A
  • Loss of excretory function
  • Loss of homeostatic function
  • Loss of endocrine function (loss of erythropoitin production and vitamin D)
  • Abnormality of glucose homeostasis (decreased gluconeogenesis)
2
Q

List the symptoms of kindey disease

A
  • Extreme lethargy, weakness, anorexia
  • Hypotension (can have hypertension)
  • Elevated urea and creatinine
  • Metabolic acidosis
  • Anaemia
  • These symptoms of tubulointerstitial disorders
  • Most common to retain sodium and have hypertension
  • Increased cardiovascular risk
3
Q

What causes symptoms of lethargy and anaemia?

A
  • Accumulation of nirogenous waste
  • Acidosis, hyponatraemia, volume depletion
  • Anaemia
4
Q

What are the complications of acidosis?

A
  • Increased H+ entry into cells in exchange for K+
  • Cause hyperkalaemia
  • Hyperkalaemia causes arrhythmias, shown by initial loss of p waves, tented t waves, bradycardia and arrest
5
Q

List the increased cardiovascular risks associated with kidney failure

A
  • Hypertension
  • Secondary cardiac effects
  • Endothelial effects
  • Lipid abnormalities
6
Q

How can acute and chronic loss of kindey function be identified?

A
  • Acute has an unchanged renal size, and no history of high creatinine
  • Chronic often has reduced kidney size, previously abnormal creatinine and chronic urearnic symptoms
7
Q

List the methods of assessing GFR

A
  • Urea
  • Creatinine
  • Creatinine clearance
  • Inulin clearance
  • Radionuclide studies
8
Q

How effective is urea in assessing GFR?

A
  • Poor indicator

- Confounded by diet, GI bleeding, drugs, liver function

9
Q

How effective is creatinine in assessing GFR?

A
  • Affected by muscle mass, age, race and sex

- Look at the patient when interpreting the results

10
Q

How effective is creatinine clearance in assessing GFR?

A
  • Difficult for elderly patients to collect a sample

- Overestimates GFR

11
Q

How effective is inulin clearance at assessing GFR?

A
  • Laborius, only used for research purposes
12
Q

How effective are radionuclide studies at assessing GFR?

A
  • EDTA clearance

- Reliable but expensive

13
Q

List the long term changes required in renal failure

A
  • Dialysis
  • Low potassium diet and fluid restriction
  • Vitamin D suppliments and erythropoietin injections