3) Chronic Kidney Disease Flashcards
Where does the glomerulus receive blood from and where does it go afterwards?
The cluster of tiny capillaries receives blood from the afferent Arterioles and filters it through to the Bowman’s Capsule
What is the normal GFR range of an adult?
The glomerular filtration rate range for an adult is 100- 125mL/min
Name the three GFR formulas.
CrCl by Cockcroft Gault
eGFR by MDRD
eGFR by CKD EPI
What occurs with creatinine levels when renal filtration is impaired?
Because this muscle metabolism byproduct is filtrate do by the glomerulus, it will become elevated when impaired.
Define the nephron.
Basical functional unit of the kidney
Composed of: Bowmans capsule, glomerulus, proximal consulted tubule, loop of Henle, distal convoluted tubule, collecting duct
The movement of substances into the tubule to be eliminated
Secretion
The movement out of the tubule into the capillaries, so the substance can be maintained in the body.
Reabsorption
What is the primary role of the proximal convoluted tubule?
Receives blood from the Bowmans capsule. This is where reabsorption and secretion occur.
What is the role of the loop of Henle?
It receives fluid from the proximal tubule. It has the role of reabsorption of mainly water, Na, Cl, and Mg.
*loop diuretics block Na and water reabsorption
Following the loop of Henle is the distal convoluted tubule which participates in the following actions:
Na and water reabsorption
K, H and phosphorous secretion
*thiazide diuretics work here
The distal convoluted tubule is followed by the collecting duct, which does these final actions:
Na reabsorption
K secretion dependant on aldosterone hormone.
Excretion of acids, therefore an acid-base balancing
*ADH affects H2O permeability of collecting duct
Why is urea only a general indicator of renal function?
Because it is reabsorbed in the kidneys and is affected by other disease processes.
Urea will increase before serum creatinine in patients with acute kidney injury
In chronic kidney disease, what occurs with the electrolyte levels?
Decreased reabsorption in the tubules causes edema and swelling through water and Na levels
Hyperkalemia (increase in blood potassium) due to inability to increase excretion through distal tubules.
Hyperphosphatemia (increase in blood phosphorous) due to inability to decrease reabsorption in proximal tubule
Hypermagnesemia (increase in blood magnesium) inability to decrease reabsorption in loop of Henle
What is the pH range that the kidneys maintain in kidney arterial blood?
7.35- 7.45
The Renin-Angiotensin System controls what?
Blood pressure
What hormone stimulates red blood cell production?
Erythropoietin in bone marrow when kidneys sense low oxygen levels.
In chronic kidney disease, what occurs in EPO levels?
EPO production goes down and there is a decrease in RBCs and hemoglobin.
What are the four types of renal failure?
Pseudo
Pre-renal
Intrinsic
Post-renal
When the renal tubular secretion of creatinine is blocked the serum creatinine levels becomes elevated, what type of renal failure is this?
Pseudo renal failure
What kind of kidney disease occurs with a decrease of blood flow to kidney, decreasing the GFR?
Pre-Renal Kidney Failure
What are the three main medical causes Pre-renal kidney issues?
Intravascular volume depletion
Decline in effective blood volume
Decrease in pressure In glomerulus
The three types of intrinsic acute kidney injury are:
Acute tubular necrosis
Acute interstitial nephritis
Glomerulonephritis
Acute tubular necrosis is the most common cause of intrinsic failure and is characterized by what?
Ischemia in the kidney which produces cell damage to tubules
*Meds that induce: aminoglycosides, amphotericin B, intravenous contrast dye
This type of intrinsic kidney injury is an inflammatory disorder of the renal interstitium with drugs being the most common of the causes.
Acute interstitial nephritis
