1b.) The Renal Patient Flashcards
State some common presentations of patients with kidney disease
- Tired
- Trouble sleeping
- Dry and itchy skin
- Need to urinate more often (and at night nocturia)
- Blood in urine
- Foamy urine
- Persisten puffiness around eyes
- Ankles and feet swollen
- Poor appetite
- Muscle cramping
Explain why someone with kidney disease may have less energy or trouble concentrating
Build up of toxins and impurities can cause you to feel tired, week and not concentrate. Patient may also be anaemic, since kidneys produce EPO, which will contribute to tiredness
Explain why someone with kidney disease may have trouble sleeping
Accumulation of toxins. Sleep apnoea (pauses or periods of shallow breathing during sleeping) more common in people with kidney disease
Is there a link betwen obesity and kidney disease?
Yes
Explain why someone with kidney disease may have dry and itchy skin
If kidneys can’t keep levels of minerals and nutrients right in your blood it can lead to mineral and bone disease which has dry and itchy skin as a symptom
Explain why someone with kidney disease may need to urinate more often
When glomeruli are damaged it can cause an increase in urge to urinate
Explain why someone with kidney disease may have blood in urine
If glomeruli are damaged then the kidneys can no longer keep all the RBC’s as they usually would so they start to leak out in urine
Explain why someone with kidney disease may have foamy urine
Protein in urine due to damaged glomeruli
Explain why someone with kidney disease may have persistent puffiness around eyes
Kidneys leaking large amount of protein in urine rather than keeping it in body
Explain why someone with kidney disease may have swollen ankles and feet
Decreased kidney function can lead to sodium and hence water retention
Explain why someone with kidney disease may have loss of appetite
Build up of toxins
Explain why someone with kidney disease may experience muscle cramping
Electrolyte imbalances such as low calcium and poorly controlled phosphorus can contribute to muscle cramping
State 5 circumstances in which you might investigate further to see if a patient has kidney disease
- Asymptomatic but abnormal investigation results
- General symptoms like tired and malaise
- Other symptoms of underlying renal impairment
- Symptoms or signs of uraemia
- Family history
When examing a patient with suspected renal disease what must you examine thoroughly
State some signs of end stage renal disease
(all those mentioned for kidney disease and..)
- Tachycardia
- Tachypnea (breath may smell uraemic)
- Hyperkalaemia
- Petechiae
- Pitting oedema
- High blood pressure
- Dry cogh
- SOB
- S3 sound
Are all patients with ESRD anaemic?
Yes
Why are patients with ESRD often vitamin D deficient?
Kidney produces enzyme (25-hydroxyvitamin D-1 alpha-hydroxylase) which converts vitamin D into biologically active vitamin D
