8- Renal diseases

Question 1

What are the functions of the renal system?

Answer 1

1.) For fluid volume
2.) Electrolyte balance
3.) Excretion of nitrogenous waste
4.) Renin synthesis (hormone production)
5.) Vitamin D activation
6.) Erythropoeitin production

Question 2

What is a nephron?

Answer 2

1.) It is the basic functional unit of the kidney

Question 3

What is the purpose of the GFR? (glomerular filtration rate)

Answer 3

It measures how much blood is filtered per minute by the kidneys

Question 4

What is the normal GFR?

Answer 4

90-120 mL/min/1.73m2

Question 5

What is chronic kidney disease?

Answer 5

It is when you lose the function of a kidney for more than 3 months.

Question 6

What is the major cause of chronic kidney disease?

Answer 6

• Diabetes
• High blood pressure

Question 7

What occurs in Stage 1 of chronic kidney disease?

Answer 7

Kidney has damage with NORMAL kidney function (90 GFR)

Question 8

What occurs in Stage 2 of chronic kidney disease?

Answer 8

Kidney damage with MILD LOSS of kidney function (89 to 60 GFR)

Question 9

What occurs in Stage 3a of chronic kidney disease?

Answer 9

Kidney damage with MILD TO MODERATE loss of kidney function (59 to 45 GFR)

Question 10

What occurs in stage 3b of chronic kidney disease?

Answer 10

Kidney damage with MODERATE TO SEVERE loss of kidney function (44 to 30 GFR)

Question 11

What occurs in Stage 4 of chronic kidney disease?

Answer 11

Kidney damage with SEVERE loss of kidney function (29 to 15 GFR)

Question 12

What occurs in Stage 5 of chronic kidney disease?

Answer 12

Kidney failure (less than 15 GFR)

Question 13

What kind of treatment is recommended for patients within stages 1 or 2 of chronic kidney disease?

Answer 13

1.) Dietary modifications:
- Low protein
- limit fluid intake
- limit electrolyte intake

2.) Management of comorbid conditions

Question 14

What is dialysis? and what are the variants of this medical treatments?

Answer 14

It is the artificial filtration of blood. It uses selective diffusion across a sem-permeable membrane to remove waste products from the body.
1.) Hemodialysis
2.) Peritoneal dialysis

Question 15

How is hemodialysis performed?

Answer 15

• It is directly from the blood
• It is the removal of waste from blood
• needs to occur 3-5X a week
• Usually at a dialysis center

Question 16

How is peritoneal dialysis performed?

Answer 16

• It is the removal of waste products using the peritoneum as the semi-permeable membrane
• Daily treatment
• Can be done from home.
• Dialysate goes into the abdomen then uses the peritoneum to filter so that i can filter out the waste products.

Question 17

What is end-stage renal disease?

Answer 17

1.) It is the advanced stage of renal disease
2.) This stage is dependent on dialysis or transplant
3.) Major systemic effect

Question 18

Where are donor kidneys usually placed?

Answer 18

They are usually placed in the groin and attached to blood vessels and the bladder. Ureter carries urine from the new kidney to the bladder.

Question 19

What are the oral manifestations of renal diseases?

Answer 19

1.) Bleeding tendency
2.) Intolerance to drugs metabolized by kidney
3.) Increased susceptibility to infection
4.) Stomatitis
5.) Ulceration
6.) Candidiasis
7.) Urine-like halitosis
8.) Petechiae

Question 20

What are the 3 dental managements used for renal diseases?

Answer 20

1.) Conservative treatment
2.) Dialysis
3.) Kidney transplant

Question 21

What are the treatment considerations for chronic kidney diseases?

Answer 21

1.) Medical consult
2.) do NOT take blood pressure from the same arm as dialysis access arm
3.) Avoid invasive treatment on the same day as dialysis
4.) Potential for increased bleeding: need for platelet count, should be reviewed
5.) Alterations in drug doses may need to be taken into account