Week 3 - Renal Disorders

Question 1

how do renal disorders commonly manifest as? (5)

Answer 1

• elevated blood urea nitrogen (BUN)
• elevated serum creatinine
• failure to maintain Na & K
• failure to maintain water balance
• acid-base imbalances

Question 2

why is it useful to get blood work on both BUN and creatine?

Answer 2

• BUN = tells us both filtration & absorption

- creatine = is only filtered, not absorbed = tells us about filtration to help us specify what is wrong

Question 3

what complications can the manifestations of renal disorders result in? (4)

Answer 3

• HTN
• symptoms of HF
• peripheral edema
• death

Question 4

what is azotemia

Answer 4

• when metabolic products that are normally excreted by the kidneys accumulate in the blood
  ex. urea, creatine, and other toxic metabolic products

Question 5

what is uremia

Answer 5

• a complex group of symptoms that occur due to inadequate renal function

Question 6

what can cause uremia (4)

Answer 6

• accumulating metabolic toxins
• fluid & electrolyte imbalances
• acidosis
• anemia

Question 7

what is oliguria

Answer 7

• diminished urine volume

<400 mL/day

Question 8

what is anuria

Answer 8

• absence of urine production

Question 9

how can renal disease be categorized? (3)

Answer 9

1. site of lesion
2. eitology
3. combo of the two

Question 10

list 2 examples of renal disease categorized based off site of lesion

Answer 10

• glomerulus vs tubule

Question 11

what are the 3 categories of renal disease categorized based off a combo of site of lesion & etiology

Answer 11

1. prerenal
2. intrarenal
3. postrenal

Question 12

what is prerenal disease?

Answer 12

• results from inadequate blood flow TO the nephron

Question 13

what are examples of causes of prerenal disease? (5)

Answer 13

• hypovolemia
• hypotension
• drug-induced reduction in perfusion
• septic shock
• stenosis of the renal arteries

Question 14

what is intrarenal disease

Answer 14

• results from intrinsic damage to the nephron

Question 15

what are examples of intrarenal disease (7)

Answer 15

• acute tubular necrosis
• glomerulonephritis
• nephrotic syndrome
• vasculitis
• malignant HTN
• diabetic nephropathy
• pyelonephritis

Question 16

what is post-renal disease

Answer 16

• results from urinary tract obstruction

Question 17

what are examples of post-renal disease (4)

Answer 17

• ureter obstruction
• prostate disease
• malignancy
• calculi

Question 18

how can renal failure be managed? (4)

Answer 18

• treat the cause
• dietary manipulation (ex. fluid, proteins, electrolytes)
• dialysis
• renal transplant

Question 19

how can we treat anemia associated with renal disease

Answer 19

• erythropoietin is used to stimulate bone marrow production of RBC

Question 20

what can we treat inflammation associated w renal disease

Answer 20

• give anti-inflammatory drugs and/or corticosteroids

Question 21

what are the 2 main categories of renal failure

Answer 21

1. acute kidney injury

2. chronic kidney disease

Question 22

describe the onset of AKI vs CKD

Answer 22

• AKI = abrupt

- CKD = gradual, often over many years

Question 23

describe the most common cause of AKI vs CKD

Answer 23

• AKI = acute tubular necrosis

- CKD = diabetic nephropathy

Question 24

describe the diagnostic criteria for AKI vs CKD

Answer 24

• AKI = acute reduction in urine output and/or elevation in serum creatinin
• CKD = measure/estimate of GFR and/or kidney damage > 3mo

Question 25

what GFR indicates CKD

Answer 25

GFR < 60 for >3 months

Question 26

describe the reversibility of AKI vs CKD

Answer 26

- AKI = potential | - CKD = progressive and irreversible

Question 27

describe the mortality of AKI vs CKD

Answer 27

- AKI = high (~60%) | - CKD = lower (19-24%)

Question 28

describe the primary cause of death for AKI vs CKD

Answer 28

- AKI = secondary infection | - CKD = cardiovascular disease