ACE Review - Renal Flashcards
How does the urine sodium look like in intrarenal oliguria
Urine Na is higher than 40 because it cannot retain sodium
How does urine osmolality look like in intrarenal oliguria
It is LESS than 350 because it cannot retain water as we’ll. sodium is being lost, but water is being lost as we’ll
What is FENa of intrarenal oliguria
It is greater than 2% because sodium is being lost
What is the specific gravity of urine in intrarenal oliguria
It is between 1.01 to 1.015 because sodium is being lost
What if the specific gravity of urine is 1.02 or higher
The oliguria is caused by prerenal causes.. The kidney is concentrating the urine and making a higher specific gravity
How does the urine osmolaity of a prerenal oliguria look like
Greater than 1000
oliguria. what is its definition
less than 0.5ml/kg/hr urine output
oliguria. what to fluids are used to compare to each other to define oliguria
compare the urine to plasma values
oliguria. what are the categories for oliguria
prerenal, renal, postobstructive
oliguria. what 4 things compared in urine and plasma can help you check for the category of oliguria
urea, creatinine, and sodium, and osmolality
oliguria. what does urine to plasma osomolality tell
the kidneys concentrating ability
oliguria. what urine to plasma osmolality value tell you it is prerenal
when it is greater than 1.5
oliguiria. what does it mean when the urine to plasma osmolality equal 1
the kidney concentration power is dead…the blood and urine both have the same osmolality
oliguria. what does urine to plasma creatinine measure
it reflects water conservation
oliguria. why is creatinine useful in diagnosing the category of oliguria
because most of creatinine is not reabsorbed
oliguria. what is seen in prerenal for urine to plasma
value greater than 30…because water is being sucked up and creatinine is being released….so [Cr] is high up to the 30s
oliguria. what is seen in renal damage of urine to plasma ratio
a value less than 20 because [Cr] is being diluted
oliguria. what is FENa
it is a measure of the kidney’s ability to conserve sodium
oliguria. what is the value of prerenal FENa
less than 1%
oliguria. what is the value of reanl damage FENa
greater than 2%
oliguria. what is so good about FENa
it includes both sodium and creatinine in its calculation
oliguira. what is the equation for FEna
(UNa/PNa) / (UCr/PCr )
oliguria. how do you compare the FENa to U:PCr for prerenal
if you think about it…they are inversus of eachother…because Na is reabosorb…and Cr is not
oliguria. how do you think the values of Urea is similar to….to Na or Cr
it is similar to sodium…it is reabsorbed by the body
oliguria. what values of prenal for FEUr
less than 35% is prerenal
oliguria. what values of intrarenal damage for FEUr
greater than 50 is intrarenal
oliguria. how much of cardiac output is directed to the kidneys
25percent
gentamycin. what should be considered during administration of this drug
pt with decrease reanl function. they are increase risk for aminoglycoside nephrotoxicity
gentamycin. does one intraop dosing increase risk for renal insufficiency
yes…even on dose can cause acute tubular necrosis
gentamycin. low lab value might show pt at risk for aminoglycoside toxicity
low albumin
gentamycin. what does low albumin level mean for pt at risk for getting acute tubular necrosis
low albumin might mean pt has low liver function…(some of these pts are hepatorenal syndrom)
gentamycin. what can be done in OR to help decrease risk of acute tubular necrosis in renal insufficient pt. what abx can be given
admin it with a betalactaminase (pcn or cephalosporins)
gentamycin. what can be done in the OR to help decrease risk of acute tubular necrosis in renal insufficient pt. what antihtn
calcium channel blocker
gentamycin. what can the pt take for supplement and help decrease risk for acute tubular necrosis
calcium supplements
