aki and ckd Flashcards
Acute kidney disease
reversible, sudden loss of kidney funcrtion accompanied by a rise in creatinine and or reduction of urine output
causes of aki
prerenal
intrinsic
postrenal
prerenal
reversible caused by: Severe blood loss and low blood pressure, can be corrected if these are corrected
ex: medication affect blood supply
surgery
intrinsic
occurs when direct damage to the kidneys causes a sudden loss in kidney function.
acute tubular necrosis, low bp, glumerular nephritis
postrenal
occurs when an obstruction in the urinary tract (bladder) below the kidneys causes waste to build up in the kidneys
just correct obstruction
examples calculi, enlarged prostate
signs of aki
hyperkaleamia
fluid retention
metabolic acidosis
treatment of aki
pharmacological therapy
renal replacement therapy
pharmacological therapy
duiretics
Antiapoptosis/Necrosis Agents
Antisepsis
renal replacement therapy
therapy that replaces the normal blood-filtering function of the kidneys.
dailysis
phases of aki
early diuretic phase
late diuretic phase
recovery phase
early diuretic phase
The kidneys try to heal and urine output increases immediately after no urine output for a long time up to 5 liters per day
late diuretic phase
urea and creatinine stop rising
recovery phase
falling of urea and creatinine levels, 60% of patient who recovered have long term damage in kidneys
nursing management of aki
accurate fluid balance
mdt approach
adequate intravascular volume and cardiac output
aseptic technique
chronic kidney disease
the progressive decline in kidney function following injury to the nephrons
end stage renal failure
esrf is the progression of ckd in which greater than 90% of the renal function has been irreversibly destroyed
last stage of ckd
stages of ckd
stage 1 more than 90 % stage 2 60-89 percent stage 3 45-59% 30-44% stage 4 15-29% stage 5 less than 15 %
causes of ckd
diabetic nephropathy glomerulonephritis hypertension polycystic kidney reflux nephropathy other uncertian
effects of ckd
peripheral nephropathy psychological pulmonary haematological ocular neurological endcroine metabolic integumentary cardiovascular gastrointestinal
when kidney fails result
decrease vit d3 activation
decrease serum calcium
excess production of parathyroid hormone
decreased phosphate excretion
in the presence of ckd
enlarged parathyroid gland secrete escess parathyroid hormone
elevated parathyroid hormone stu=imulate the release of
calcium and phosphate from bones adding to ingested calcium and phosphate
normal renal function balances the
calcium phospate and parathyroid gland
excess production of parathyroid hormone cuases
increases calcium and phospate
decreases of bone strength
calcium deposit
treatment of esrf
haemodialysis
peritoneal dialysis
transplant
supportive care
management of ckd
early diagnosis
dehydration
infection
medications
dietary management
restriction on protein, sodium,phosphate, potassium, energy
nursing interventions
education/ health promotion hypertension diabetes management patient advocate timely mdt referral
