AKI and CKD Flashcards
what are the 3 important endocrine functions of the kidneys
- produces erythropoietin which stimulates RBC production
- activates vitamin D
- produces renin which regulates BP
what % of normal GFR is considered renal insufficiency?
25% of normal
what is a normal GFR?
> 90
what is usually the cause of an acute kidney injury?
volume loss which leads to decreased perfusion
what are the three classifications of acute kidney injury?
- pre renal
- intra renal
- post renal
what is included for a pre renal acute kidney injury?
volume loss
what is included for an intra renal acute kidney injury?
acute tubular necrosis from chemicals, overdose, glomerulonephritis, diabetes complications, and kidney cell death
what is included for post renal acute kidney injury?
obstruction that leads to cell death
what are the clinical manifestations of acute kidney injury?
-oliguria
-FVE
-metabolic acidosis
-HYPOnatremia
-hyperkalemia
-azotemia
-neurologic disorders
how soon after a hypotensive event can an acute kidney injury begin to show - how long can it last?
begins 1 day after, can last 1-3 weeks
what is ultimately the best treatment for acute kidney injury?
prevention and treating diseases that cause acute kidney injury
what is the GFR associated with stage 5 of chronic kidney disease?
< 15
what stages of chronic kidney disease typically are asymptomatic?
stage 1 and 2
what is the main manifestation of stage 5 chronic kidney disease?
uremic
what are the risk factors of chronic kidney disease?
- family hx
- CAD, atherosclerosis, and hyperlipidemia
- increasing age
- male
- black / african american
- HTN, DM, smoking
- overweight / obese
what is the clinical manifestation related to the decreased activation of vitamin D in relation to chronic kidney disease?
renal osteodystrophy
what is the clinical manifestation related to the decreased production of erythropoietin in relation to chronic kidney disease?
anemia
what are the clinical manifestations related to the inability to rid the body of wastes via urine in relation to chronic kidney disease?
anorexia ,malnutrition, itching, CNS changes
what are the clinical manifestations related to the inability to maintain F&E homeostasis related to chronic kidney disease?
edema, hyperkalemia, hyperphosphatemia, hypermagnesemia, metabolic acidosis
what is the best drug to fix the damage done to the kidneys during chronic kidney disease?
none
with chronic kidney disease what do you want to lower the BP to?
less than 140/90
what is the commonly used drug to treat volume overload associated with chronic kidney disease?
loop diuretics
what type of diet is typically recommended in conjunction with loop diuretic therapy in chronic kidney disease?
low salt diet
what is the commonly used drug for hyperkalemia with chronic kidney disease?
multiple diuretics
what is the commonly used drug to address metabolic acidosis in the case of chronic kidney disease?
sodium bicarbonate
what is the commonly used drug to address hyperphosphatemia in the case of chronic kidney disease?
calcium carbonate
what is the commonly used drug to address renal osteodystrophy in the case of chronic kidney disease?
calcitrol
what is the commonly used drug to address anemia in the case of chronic kidney disease?
erythropoietin
what drugs should the nurse pay special attention to if the patient has impaired kidney function?
- digoxin
- glyburide, metformin
- antibiotics like vancomycin
- opioids like morphine
