5. Renal

Question 1

Functions of kidneys (2)

Answer 1

1. Regulate acid-base and fluid-electrolyte balance of body
   - Secrete renin, calcitriol, erythropoietin, renal prosthoglands
2. Excrete metabolic waste products

Question 2

Two main indicators of renal dysfunction

Answer 2

1. Hematuria
   - Bleeding along urinary tract
2. Proteinuria (most sensitive sign of renal failure)

Question 3

At what point does renal decline begin?

Answer 3

Declines after 50% of nephrons destroyed

Question 4

Normal range of GFR and comparison to renal failure?

Answer 4

Normal: 100 to 150 mL/min
Failure: <6-10 mL/min

Question 5

Normal range of creatinine clearance

Answer 5

Females: 85-125 mL/min
Failure: 10-50 mL/min

Males: 97-140 mL/min
Failure: <10 mL/min

Question 6

Normal range of serum creatinine

Answer 6

0.6-1.20 mg/dL

Failure: >5 mg/dL

Question 7

Normal range of Blood urea nitrogen

Answer 7

8-18 mg/dL

Failure > 50 mg/dL

Question 8

Which decrease and which increase?

• Serum calcium
• Serum phosphate
• Serum potassium

Answer 8

Calcium depressed

Phosphate and potassium elevated

Question 9

Most common cause of renal failure is pre or post renal failure?

Answer 9

Pre-renal failure - compromise of renal flow (volume depletion, cardiovascular disease, changes in fluid volume)

Question 10

Chronic renal failure - s/sx

Answer 10

1. Anorexia, nausea, vomiting, GI distress
2. Mental slowness
3. Hyperpigmentation
4. Uremic frost, odor
5. Oral ulcers
6. Easily bruise, gingival bleeding, epistaxis
7. HTN, CHF
8. Sexual dysfunction

Question 11

Dental management concerns for renal disease

Answer 11

1. Medical consult
2. Bleeding
3. Infection
4. Medications (nephrotoxicity, metabolism, dosage adjustments)
5. Anemia
6. Timing of treatment with hemodialysis patients

Question 12

Three drugs commonly used in dental practice to avoid in ESRD patient

Answer 12

ASA
NSAIDs
Acyclovir