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Clinical Biomedicine > W3: Kidneys > Flashcards

W3: Kidneys Flashcards

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1
Q

2 main parts of kidney

A

glomerulus
tubule

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2
Q

6 kidney functions

A
  • reg vol of fluid in blood
  • electrolyte balance
  • acid-base balance
  • excretion of waste prods
  • vit D metabolism
  • prod of erythropoietin
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3
Q

3 waste products that kidneys excrete

A
  • creatinine (from skeletal muscle)
  • urea
  • uric acid
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4
Q

what component filters the fluid?

A

Bowman’s/ glomerular capsule

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5
Q

2 renal function tests

A
  • GFR (glomerular filtration rate
  • measurement of waste prods in plasma
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6
Q

what does GFR measure

A

vol of fluid filtered through all glomeruli per time unit

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7
Q

normal GFR

A

60-120ml/ min

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8
Q

what is eGFR + what’s it based on

A

estimated glomerular filtration rate
based on an equation validated against gold standard renal clearance test

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9
Q

normal eGFR

A

> 90ml/ min

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10
Q

what does decreasing eGFR indicate

A

impairment of renal function

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11
Q

2nd renal function test?

A

measurement of waste prods in plasma e.g creatinine + urea

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12
Q

problem of using creatinine as measure of renal function

A

not a sensitive marker of renal function - stays within normal ranges even when chronic renal disease already established

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13
Q

what is urea a waste prod of

A

protein + AA metabolism

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14
Q

problem w urea measuring for renal function? when may it be useful?

A
  • poor indicator of renal function (influenced by protein metabolism, the state of dehydration + use of steroids)
  • may be useful in elderly/ children w dehydration as starts to rise b4 creatinine - becomes more concentrated
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15
Q

how is acid-base balance maintained?

A

by renal:
- secretion of H+
- reabsorption of HCO3-

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16
Q

high [H+] w/out renal buffering causes?

A

metabolic acidosis

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17
Q

low [H+] w/out renal buffering causes?

A

metabolic alkalosis

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18
Q

2 renal function-related test that are indirectly affected in renal failure?

A
  • plasma phosphate bc kidney involved in phosphate excretion
  • plasma Ca2+ - bc kidney involved in active vit D prod
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19
Q

what may cause low calcium in ACUTE renal failure?

A

raised phosphate in plasma

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20
Q

what may cause low calcium in CHRONIC renal failure?

A

low 1,25 diOHvitamin D3

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21
Q

what does glomeruli damage cause?

A

protein to leak into tubules + they can’t reabsorb enough protein back into bloodstream

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22
Q

when small-middle sized proteins can’t be reabsorbed it can lead to?

A

albuminuria

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23
Q

as renal disease progresses bigger proteins get through leading to?

24
Q

what particular renal condition shows considerable proteinuria?

Study These Flashcards
A

nephrotic syndrome

25
what can cause acute onset of decr renal function?
- hypovolaemia secondary to blood loss, dehydration, shock - glomerulonephritis drugs affecting glomeruli/ tubules - rhabdomyolysis - obstruction of renal blood/ urine flow
26
define glomerulonephritis
acute inflammatory process affecting glomeruli
27
define rhabdomyolysis
massive muscle breakdown
28
what does decr GFR in acute renal failure (RF) lead to?
rapid decr of urine vol may show anuria (no urine output) in severe cases
29
how does acute renal failure (RF) affect waste prods
incr in waste prods e.g plasma urea + plasma creatinine
30
how does acute RF affect electrolytes
incr in electrolytes e.g plasma K+ + plasma phosphate
31
how does acute RF affect acids
incr as kidneys are not excreting them
32
how does acute RF affect plasma Na+
incr/ decr/ normal dpending on cause usually decr due to H2O retention making plasma more dilute
33
muscle test determined based on quantity of which enzyme
creatine kinase
34
what can be present in urine indicating acute RF that is usually absent
myoglobin (toxic to kidneys)
35
creatine kinase high or low in acute RF + why
high bc leaks out into blood when skeletal tissue damaged
36
define chronic renal failure (CRF)/ chronic kidney disease (CKD)
GRADUAL decline of renal function over yrs
37
causes of CRF/ CDK
- diabetes (diabetic nephropathy) - hypertension - diseases affecting glomeruli/ tubules/ interstitium
38
abnormal if eGFR is
<60ml/ min
39
abnormal value range of GFR
60-90 w other features of CDK
40
why is creatinine not a good marker for CDK
only starts rising when >70% of renal function has been lost
41
how does CDK affect waste prods
incr in them: - plasma urea - plasma creatinine
42
how does CDK affect electrolytes
incr plasma K+ (late on) incr plasma phosphate (late on)
43
what happens to plasma Ca+ in CDK + why
normal or decr due to decr active vit D prod
44
what hormones affect Na+, H2O & K+
adrenals: renin/ angiotensin/ aldosterone axis
45
what hormone only affects H2O
post pit: ADH/ AVP
46
define hyponatraemia
[Na+] in your blood is abnormally low and/ or excess H2O
47
why is hyponatraemia important
can dilute conc of ions a lot
48
define hypernatraemia
incr [Na+] usually due to loss of H2O rarely bc excess Na+
49
why is hypernatremia important
water drawn out of cells by osmosis, cells get smaller
50
acidosis usually associated w incr or decr serum K+?
incr
51
alkalosis usually associated w incr or decr serum K+?
decr
52
value for hyperkalaemia
plasma K+ >5.5 mmol/L
53
causes of hyperkalaemia
- artefacts: haemolysis, cold weather, delayed sample processing, high platelets - incr intake of K+ - incr renal reabsorption - decr loss e.g. chronic/ acute RF
54
why is hyperkalaemia important
changes to heart rhythm (arrhythmia)
55
value for hypokalaemia
plasma K+ < 3.5 mmol/L
56
causes of hypokalaemia
- artefacts: hot weather during blood storage - decr intake of K+ - decr renal reabsorption - incr loss: vomiting/ diarrhoea / kidneys
57
why is hypokalaemia important
changes to heart rhythm (arrhythmia) muscle weakness

Clinical Biomedicine (23 decks)

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