acute and chronic kidney Flashcards
acute renal failure
the kidneys fail to remove metabolites from the blood
chronic kidney disease
gradual destruction of nephrons
prerenal definition and causes
- before renal failure
- outside source
- hypoperfusion
- increased creatinine
intrarenal definition and causes
- internal
- damage to renal parenchyma and nephrons
postrenal definition and causes
- after renal failure
- result of obstruction
- commonly associated with BPH and renal calculi
AKI has a _____ progression
rapid
CKD has a _____ progression
slow
what type of disorders increase the risk for CKD
vascular disorders
risk factors for AKI
- trauma
- surgery
- infection
- urinary tract obstruction
- nephrotoxic drugs
- use of contrast media
phases of AKI
- initiation
- maintenance
- recovery
initiation phase of AKI
- start of event to onset of tubular necrosis
- lasts from hours to days
- pt is asymptomatic
maintenance phase of AKI
- decrease in glomerular filtration rate and worsening of tubular necrosis
- pt experiences symptoms
recovery phase of AKI
- tubule cell regeneration
- diuresis
- lasts 5 days to 1 year
clinical manifestations for AKI
- oliguria
- metabolic acidosis (confusion, agitation, seizures)
- hyperkalemia (muscle weakness, ECG changes)
- hyponatremia (decreased LOC, seizures)
- hypocalcemia (muscle spasms/twitching, Chvostek sign)
electrolyte disturbances with AKI
- hyperkalemia
- hyponatremia
- hypocalcemia
fluid management for a pt with AKI
- fluid restriction (insensible water loss (500mL) + urine output)
- accurate I+O
diet for AKI pt and why
low-protein diet d/t how hard protein is on the kidneys
what does a dialysate mimic?
extracellular fluid
what happens during hemodialysis
removal of electrolytes, waste and excess water
5 causes for CKD
- damage to nephrons
- subsequent hypertrophy of remaining nephrons
- increase nephrotic pressure
- Glomerular sclerosis
- nephron destruction
risk factors for CKD
- diabetes
- HTN
electrolyte disturbances with CKD
- hypocalcemia
- hyper/hypomagnesemia
- hyperkalemia
ESRD
end-stage renal disease
ESRD manifestations
- Kussmaul respirations
- HTN
- edema
- anemia
- decreased platelet function
- decreased immunity
- delayed inflammatory response
- uremic fetor
- seizures
- osteoporosis
- increased BUN, crt, uric acid
- uremic frost
stage 1 of CKD
- kidney damage with normal or increased GFR
- asymptomatic; normal BUN and creatinine
stage 2 of CKD
- mildly decreased GFR
- asymptomatic; possible HTN; blood work generally within normal limits
stage 3 of CKD
- moderate GFR decrease
- HTN; possible anemia and fatigue, anorexia, possible malnutrition, bone pain, slight elevation of BUN and serum creatinine
stage 4 of CKD
- severely decreased GFR
- HTN, anemia, malnutrition, altered bone metabolism; edema, metabolic acidosis, hypercalcemia, possible uremia, azotemia, increasing BUN and creatinine levels
