9 - Clinical renal failure and tests

Question 1

Renal failure def

Answer 1

Is essentially a low GFR and high creatinine

Question 2

What is normal GFR?

Answer 2

100 mL/min

Question 3

Signs vs symptoms?

Answer 3

signs - what you find on examination i.e. BLOODS

symptoms - what the patient tells you. Are often vague

Question 4

Blood tests?

Answer 4

Serum creatinine and urea

Question 5

What is serum creatinine?

Answer 5

It is a muscle waste/break down product. The serum levels are an indication of how well the kidneys are clearing this from the body

Question 6

Plasma urea?

Answer 6

Main excretory product of waster nitrogen

Question 7

What is creatinine a surrogate measure for?

Answer 7

How much muscle waste product is produced and how well the kidenys are getting rid of the waste product

Question 8

Equation to calculate eGFR includes?

Answer 8

• age
• gender
• race (black)
• creatinine and so muscle mass

Question 9

When may egfr be inaccurate?

Answer 9

If muscle mass is unusually high or low i.e. amputees, muscle wasting, bodybuilders
Is only valid for patients in steady state i.e. stable creatinine levels. Not valid if rising/failing like in renal injury or failure

Question 10

Does dialysis make the kidneys better?

Answer 10

No - keeps you alive while the kidneys repair themselves

Question 11

2 differences between AKI and CKD?

Answer 11

CKD: irreversible and usually has normal urine output while AKI has oliguria. It is a gradual decline in kidney function over months/years

Question 12

HT seen in AKI or CKD?

Answer 12

CKD seen in CKD, hypotension is a non-renal cause of AKI