Acute Renal Failure and Chronic Kidney Disease Flashcards

1
Q

What do kidneys do?

A

Filtration!

make/release erythropoietin ( to stimulate RBC manufacturing)

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2
Q

What are some things Kidneys filter?

A

BUN - blood urea nitrogen
Creatinine (muscle waste product)
Sodium ( fluid volume)
Potassium ( regulates heart)

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3
Q

What is the normal potassium level? Why is it important for potassium to stay within this range?

A

3.5-5 UNITS???

elevated or decreased potassium levels can kill someone

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4
Q

What can happen to Kidney patients?

A

a lot of different things because the kidney filters many things that affect other systems and organs

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5
Q

What is the functional unit of the Kidney?

A

Nephron

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6
Q

What is the Nephron made up of?

A
Glomerulus
Proximal Convoluted Tubule
Loop of Henle
Distal Convoluted Tubule
Collecting Duct
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7
Q

Where is the Glomerulus located? What does it do?

A

located in the Bowman’s Capsule

Filters - made up of a bunch of capillaries

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8
Q

What does the Proximal Convoluted Tubule do?

A

drains the Bowman’s Capsule, reabsorbs electrolytes, plays a part in the buffer system (acid/base balance)

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9
Q

What is the purpose of the Loop of Henle?

A

reabsorbs water (controls the concentration of urine)

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10
Q

What is Glomerulonephritis?

A

a group of diseases that results from inflammation or injury to the glomerulus

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11
Q

What are the First - Third leading causes of Renal Failure?

A
#1 = Diabetes
#2 = HTN
#3 =  Glomerulonephritis
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12
Q

What causes Glomerulonephritis?

A

damage to the glomerulus

- HTN, Stress, Drugs, Infection, Diabetes

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13
Q

What are the manifestations of Glomerulonephritis?

A
headache
^ BP
facial/periorbital edema
lethargic
low grade fever
weight gain (edema)
Proteinuria
Hematuria
Oliguria
Dysuria
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14
Q

Proteinuria

A

protein in the urine

damaged capillary beds in the kidney so the proteins leaks out

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15
Q

Hematuria

A

blood in the urine

damaged capillary beds in the kidney so blood leaks out

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16
Q

Oliguria

A

No urine output

*have edema because they are holding onto water/sodium

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17
Q

Dysuria

A

painful urination

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18
Q

What is Nephrotic Syndrome

A

another name for Glomerulonephritis

Increase in the glomerular permeability resulting in a decrease in GFR

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19
Q

How will a person with Nephrotic Syndrome present due to change in permeability?

A
massive proteinuria
generalized edema
ascites
hyperlipidemia
hypoalbuminemia
hypoproteinemia (less protein in blood because they are urinating them out)
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20
Q

What is Nephrotic Syndrome characterized by?

A

an increase in capillary permeability in the glomerulous

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21
Q

How can Asymptomatic Glomerulonephritis be detected?

A

a simple urine sample

22
Q

What is Primary Glomerulonephritis?

A

caused by an infection of the kidney

23
Q

What is Secondary Glomerulonephritis?

A

not initially a kidney based issue

e.g. diabetes, drugs/NSAIDs, etc.

24
Q

What is Pyelonephritis?

A

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

25
Q

What is Polycystic Kidney Disease?

A

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

26
Q

Describe the progression of Polycystic Kidney Disease.

A

progresses slowly but will eventually lead to renal failure

27
Q

What is the treatment for Polycystic Kidney Disease?

A

control blood pressure

keep patient free of infection (UTI)

28
Q

What are the manifestations of Polycystic Kidney Disease?

A

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)

29
Q

What is Hydronephrosis?

A

an obstructive disorders

urine filled dilation of the renal pelvis due to obstruction of urine outflow (water inside the kidney)

30
Q

What will untreated Hydronephrosis lead to?

A
atrophy of kidney
distended ureter
distended kidney
Kidney could burst 
kidney could become "shot"
31
Q

What is the damaging effect of Hydronephrosis?

A

urinary stasis

- higher risk of infection

32
Q

What is one specific cause of Hydronephrosis?

A

Kidney Stones (renal calculi)

33
Q

What are Renal Calculi?

A

stones that form in any part of the urinary tract

34
Q

What are the types of Renal Calculi (things they are made of)?

A
  1. Calcium (most common)
  2. Uric acid
  3. Struvite
  4. Cystine (less common)
35
Q

What is the most common type of renal calculi?

A

calcium

36
Q

Where does uric acid come from?

A

purines

- animal proteins, alcohol intake, obesity

37
Q

What type of Renal Calculi are usually seen after an UTI?

A

Struvite

38
Q

What puts a patient at a higher risk for developing Uric Acid Renal Calculi?

A

consumption of animal proteins (red meats), alcohol

being obese

39
Q

What other disease/disorder have we learned about that is also associated with Uric Acid beside the formation of Kidney stones?

A

Gout

40
Q

What is Diabetic Nephropathy?

A
  • most common single cause of renal failure
  • elevated blood sugars
  • increased renal workload
  • protein leakage (Microalbuminuria, Macroalbuminuria)
41
Q

What is Microalbuminuria?

A

small amount of albumin (a protein) in urine

one of the 1st signs of Kidney Failure

42
Q

What is Macroalbuminuria?

A

large amount of albumin (a protein) in urine

occurs closer to the end stages of renal disease

43
Q

How does elevated blood sugar ruin kidneys? -diabetic patient

A
  • 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)
44
Q

What is Renal Cell Carcinoma?

A

malignancy of the kidney (cancer)

  • generally found accidently while tending to other issues unrelated
45
Q

What is highly linked to Renal Cell Carcinoma?

A

smoking

46
Q

What are some other risk factors of Renal Cell Carcinoma?

A
  • male
  • over 50
  • family history
  • long term abuse of OTC analgesics (ex. Tylenol, Motrin, NSAIDs)
  • smoking
  • being on dialysis
47
Q

What are the S/S of Renal Cell Carcinoma?

A

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
48
Q

What is Renal Replacement Therapy?

A

Dialysis

49
Q

How often should Type 1 diabetics be tested for Microalbuminuria (proteinuria)

A

should be tested 5 years after diagnosis then yearly after that

50
Q

How often should Type 2 be tested for Microalbuminuria (proteinuria)?

A

should be tested right after diagnosis and then yearly after that

*at a greater risk than type 1