Acute Renal Failure and Chronic Kidney Disease Flashcards
What do kidneys do?
Filtration!
make/release erythropoietin ( to stimulate RBC manufacturing)
What are some things Kidneys filter?
BUN - blood urea nitrogen
Creatinine (muscle waste product)
Sodium ( fluid volume)
Potassium ( regulates heart)
What is the normal potassium level? Why is it important for potassium to stay within this range?
3.5-5 UNITS???
elevated or decreased potassium levels can kill someone
What can happen to Kidney patients?
a lot of different things because the kidney filters many things that affect other systems and organs
What is the functional unit of the Kidney?
Nephron
What is the Nephron made up of?
Glomerulus Proximal Convoluted Tubule Loop of Henle Distal Convoluted Tubule Collecting Duct
Where is the Glomerulus located? What does it do?
located in the Bowman’s Capsule
Filters - made up of a bunch of capillaries
What does the Proximal Convoluted Tubule do?
drains the Bowman’s Capsule, reabsorbs electrolytes, plays a part in the buffer system (acid/base balance)
What is the purpose of the Loop of Henle?
reabsorbs water (controls the concentration of urine)
What is Glomerulonephritis?
a group of diseases that results from inflammation or injury to the glomerulus
What are the First - Third leading causes of Renal Failure?
#1 = Diabetes #2 = HTN #3 = Glomerulonephritis
What causes Glomerulonephritis?
damage to the glomerulus
- HTN, Stress, Drugs, Infection, Diabetes
What are the manifestations of Glomerulonephritis?
headache ^ BP facial/periorbital edema lethargic low grade fever weight gain (edema) Proteinuria Hematuria Oliguria Dysuria
Proteinuria
protein in the urine
damaged capillary beds in the kidney so the proteins leaks out
Hematuria
blood in the urine
damaged capillary beds in the kidney so blood leaks out
Oliguria
No urine output
*have edema because they are holding onto water/sodium
Dysuria
painful urination
What is Nephrotic Syndrome
another name for Glomerulonephritis
Increase in the glomerular permeability resulting in a decrease in GFR
How will a person with Nephrotic Syndrome present due to change in permeability?
massive proteinuria generalized edema ascites hyperlipidemia hypoalbuminemia hypoproteinemia (less protein in blood because they are urinating them out)
What is Nephrotic Syndrome characterized by?
an increase in capillary permeability in the glomerulous
How can Asymptomatic Glomerulonephritis be detected?
a simple urine sample
What is Primary Glomerulonephritis?
caused by an infection of the kidney
What is Secondary Glomerulonephritis?
not initially a kidney based issue
e.g. diabetes, drugs/NSAIDs, etc.
What is Pyelonephritis?
a Tubulointerstitial Disorder
infection of the kidney usually caused by an ascending bladder infection, could also be caused by blood born infection (septicemia)
can have Chronic Pyelonephritis which could lead to chronic renal failure
-Intrarenal reflux - reflux of urine into parenchymal tissue of the kidney
What is Polycystic Kidney Disease?
a Tubulointerstitial Disorder
PKDs are a group of INHERITED kidney disorders characterized by fluid-filled sacs or segments that have origins in the tubular structures of the kidney
Describe the progression of Polycystic Kidney Disease.
progresses slowly but will eventually lead to renal failure
What is the treatment for Polycystic Kidney Disease?
control blood pressure
keep patient free of infection (UTI)
What are the manifestations of Polycystic Kidney Disease?
pain from enlarged cysts on the kidney
episodes of gross hematuria (cysts bleeding)
HTN b/c they have compression of blood vessels and activates renin-angiotensin mechanism (regulation mechanism that doesn’t need to be activated then which is why it causes HTN)
What is Hydronephrosis?
an obstructive disorders
urine filled dilation of the renal pelvis due to obstruction of urine outflow (water inside the kidney)
What will untreated Hydronephrosis lead to?
atrophy of kidney distended ureter distended kidney Kidney could burst kidney could become "shot"
What is the damaging effect of Hydronephrosis?
urinary stasis
- higher risk of infection
What is one specific cause of Hydronephrosis?
Kidney Stones (renal calculi)
What are Renal Calculi?
stones that form in any part of the urinary tract
What are the types of Renal Calculi (things they are made of)?
- Calcium (most common)
- Uric acid
- Struvite
- Cystine (less common)
What is the most common type of renal calculi?
calcium
Where does uric acid come from?
purines
- animal proteins, alcohol intake, obesity
What type of Renal Calculi are usually seen after an UTI?
Struvite
What puts a patient at a higher risk for developing Uric Acid Renal Calculi?
consumption of animal proteins (red meats), alcohol
being obese
What other disease/disorder have we learned about that is also associated with Uric Acid beside the formation of Kidney stones?
Gout
What is Diabetic Nephropathy?
- most common single cause of renal failure
- elevated blood sugars
- increased renal workload
- protein leakage (Microalbuminuria, Macroalbuminuria)
What is Microalbuminuria?
small amount of albumin (a protein) in urine
one of the 1st signs of Kidney Failure
What is Macroalbuminuria?
large amount of albumin (a protein) in urine
occurs closer to the end stages of renal disease
How does elevated blood sugar ruin kidneys? -diabetic patient
- your cells are starving/dying because sugar cannot enter the cells
- 2 of the most sensitive areas to this effect are the kidneys and eyes
- high levels of sugar also makes the kidney work harder to get rid of some sugar (wears kidneys out)
What is Renal Cell Carcinoma?
malignancy of the kidney (cancer)
- generally found accidently while tending to other issues unrelated
What is highly linked to Renal Cell Carcinoma?
smoking
What are some other risk factors of Renal Cell Carcinoma?
- male
- over 50
- family history
- long term abuse of OTC analgesics (ex. Tylenol, Motrin, NSAIDs)
- smoking
- being on dialysis
What are the S/S of Renal Cell Carcinoma?
hematuria
abdominal mass
unintentional weight loss
fatigue
- symptoms don’t appear until the disease has progressed (metastasized)
- one of those cancers that creeps up on you
What is Renal Replacement Therapy?
Dialysis
How often should Type 1 diabetics be tested for Microalbuminuria (proteinuria)
should be tested 5 years after diagnosis then yearly after that
How often should Type 2 be tested for Microalbuminuria (proteinuria)?
should be tested right after diagnosis and then yearly after that
*at a greater risk than type 1
