8. Renal Flashcards
What are the 5 main functions of the kidneys?
Removes waste and extra fluid Control and blood pressure Makes red blood cells Keeps bones healthy Controls pH levels
How does a loop diuretic work?
Inhibits the outflux of sodium leading to less water moving out the collecting duct into the urine
e.g. furesomide
Explain the concept behind acid base balance?
The key is the PH
If CO2 is up and pH is up- respiratory acidosis
If CO2 is up and pH is down- metabolic alkalosis
If HCO3 is up and pH is down- metabolic alkalosis
If HCO3 is up and pH is up- Respiratory acidosis
What is normal GFR?
125mls a min
How is inulin used to measure GFR?
It cannot pass through the tubules of kidneys. This means that any inulin secreted must have passed through the glomerulus and nowhere else.
Due to this we can measure the GFR and the GFR only
What does aldosterone do?
Promotes potassium loss
What is ADH secreted in response to?
Low blood/water volumes. Secreted to riase water resorption
What does each zoen of the adrenals secrete?
Zona glomerulosa- mineralcorticoids (aldosterone)
Zona fasiculata- glucocoritcoids (cortisol)
Zone reticularis- androgens
medulla- stress hormones (epinepherine)
Whats the difference between osmolarity and tonicity?
Osmolarity- penetrating and non penetrsating solutions
Tonicity- non penetrating solutions (osmotic drag)
What is the role of renin?
Produced in situations that require an increase in blood pressure e.g. exercise and hypotension
it activates angiotensinogen release
How does angiotensin II work?
derived from angiotensinogen. It acts too:
Increase blood pressure,
Increase aldosterone production
Increase ADH production
Aldosterone regulates blood pressure
How do you stage kidney disease?
Kidney damage/normal or high GFR (>90) STAGE 1
Kidney damage (60-89) STAGE 2
Moderately impaired (35-60) STAGE 3
Severely impaired (15-29) STAGE 4
Advanced or dialysis (<15) STAGE 5
What are the immediate dangers of AKI?
Acidosis Electrolte imbalance Intoxicatioon TOXINS overload Uraemic omplications
What are the differnet ways AKI’s arise?
Pre renal- sepsis, hypovolaemia
Intrinsic (rhabdomyolosus, heamoglobinuria, toxins)
Post-renal- kidney stones, prostatic hypertrophy, tumours, retro peritoneal fibrosis
How do you treat hyperkaeaemia?
Stabilise- calcium glucanate
Shift- insulin-dexstrose
Remove- dialysis
