what are the 5 major functions of the kidney?
- removal of water and wastes
- maintains electrolyte balance
- maintains acid-base balance
- regulates BP by renin secretion
- stimulates production of RBC by erythropoietin secretion
what is GFR and what are the factors that determine GFR?
- it is a test to measure the level of kidney function & determine the stage of the kidney disease
- total surface area available for filtration (number of nephrons
- filtration membrane permeability
- net filtration pressure
what is oliguria?
<300-500ml/day of urine
what is anuria?
<50ml/day of urine
how does hypertension affect the kidneys?
it can cause impaired blood flow to the kidney causing hypertrophy
what is renal failure?
is a decreased pr cessation of glomerular filtration
what is chronic kidney disease?
is a progressive & irreversible decline in GFR
what is acute kidney injury?
is an abrupt decrease or cessation of GFR or kidneys stop working
- it is reversible if patient gets correct and prompt treatment
what are the causes of acute kidney disease?
- complication of surgery
- renal ischemia caused by blood clots
- drugs (antibiotics, NSAIDs)
- toxins (enviro)
- heatstroke
- multiple organ failure
- sepsis
- kidney stones
what causes pre-renal kidney disease?
it is associated with lack of blood supply/low BP
what causes renal kidney disease?
it affects the nephrons directly
what causes post-renal kidney disease?
mostly due to back back pressure due to obstructions
what are the causes of chronic kidney disease?
- diabetes
- hypertension
- obstructive nephronpathy caused by kidney stones
- kidney disease
- renal artery stenosis
- lead poisoning
- fatty plaque deposits
what are the stages of chronic kidney disease?
- diminished renal flow
- renal insufficiency
- end stage
what occurs during stage 1 (diminished renal flow)?
- no signs and symptoms
what occurs during stage 2 (renal insufficiency)?
- waste products build up
- inability to concentrate or dilute urine
- 75% or more nephrons are lost
what occurs during stage 2 (end stage)?
- oliguria present
- waste product build up
- treatment required
- 90% or more nephrons are lost
what are renal function tests?
- GFR: urine concentration X urine flow
plasma concentration - Creatinine clearance rate (CCr or CrCl):
is the volume of blood plasma that is cleared of creatinine per unit time
where is creatinine produced?
it is produced naturally by the body & is freely filtered by the kidneys
what is the treatment in renal failure?
- continuous ambulatory peritoneal bypass (CAPD)
- haemodialysis
- renal transplant
steps for getting a renal transplant?
- have a suitable donor so the blood groups match
- need regular checks for rejection of kidney
- need immunosuppressive medication
what is the difference between haemodialysis and CAPD?
- CAPD is continous and machine free, 21 hour per week, $
- haemodialysis is a machine that takes about 18-30 hours of your week and is $$$
what are some dietary interventions when on dialysis?
- decreased fluid intake
- decreased sodium
- decreased potassium
- decreased protein
- decreased carbohyrate/calorie intake
how does salt (NaCl) effect your body?
- can increase BP, increase thirst
