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Flashcards in WEEK 5: RENAL Deck (6)
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1

RENAL INSUFFICIENCY

- Partial or complete kidney function impairment
- Leads to poor excretion of waste products and water and functional disturbance for all body systems
- Acute renal failure or Chronic renal disease

2

CHRONIC KIDNEY DISEASE

- Also known as chronic renal disease→ A progressive loss in renal function over a period of months or years
- A person can lose up to 90% of their kidney function before experiencing any symptoms
- 1 in 9 Australians over 25 have one clinical sign for CKD (reduced kidney function, proteinuria or haematuria)

3

CKD AETIOLOGY

- Diabetic nephropathy
- Hypertension
- Glomerulonephritis
- HIV nephropathy
- Reflux nephropathy in children
- Polycystic kidney disease
- Kidney infections and obstructions

4

DELIRIUM AND DSM CRITERIA

- Acute alteration of mental state that is related to a physical cause
1) Disturbed attention and awareness
2) Disturbance develops over a short period of time, is a change from baseline, tends to fluctuate in severity over the day
3) An additional disturbance in cognition
4) (1) and (3) are not better explained by another pre-existing, established or evolving neurocognitive disorder (e.g. dementia) nor in context of severely reduced level of consciousness, such as coma
5) Evidence of an aetiological cause

5

DELIRIUM; PREDISPOSING RISK FACTORS

- Age >70 years
- Severe medical illness
- Pre-existing cognitive impairment (e.g. dementia)
- Depression
- Alcoholism
- Malnutrition
- Functional impairment
- Sensory impairment

6

DELIRIUM: PRECIPITATING FACTORS

- Psychotropic medications
- Polypharmacy
- Infection
- Dehydration
- Indwelling catheter
- Physical restraints
- Alcohol or drug withdrawal
- Hypoxic encephalopathy
- Metabolic (e.g abnormal serum sodium, low serum albumin)
- Pain