AKI and CKD Exam 2 Flashcards
Kidney Functions
Main fluid and electrolyte homeostasis
Rid the body of water-sulable wastes via urine
3 important endocrine functions
Kidney: Three important endocrine functions
Produce erythropoietin - stimulates RBC production
Activates Vitamin D
Produces renin, which helps regulate blood pressure
Why is kidney injury such a large problem?
Kidneys are NEEDY
Renal blood flow = 1 L per min = 20% CO
Kidney injury can be sudden and rapidly progress (can take a hit and happen in hours)
BUT: Can be reversible
Renal insufficiency
90 ml/hr is normal GFR in healthy
25% of normal GFR 25-30 ml/hr indicates Renal insufficiency
What is indicator of kidney injury
GFR <90 but GFR is not always indicator of acute kidney injury
3 Classifications of AKI
Based on where the injury is occuring
Pre-renal
Intrarenal
Post-renal
Pre-Renal AKI
Do you volume loss. Hypotension or hypovolemia
Intrarenal AKI
Acute tubular necrosis. This happens within the kidney. Drug overdose.
DM and HTN
Post Renal AKI
Not as common. Obstruction causing cell death. BPH
AKI: Clinical Manifestations
Oliguria = <400 ml/24 hr period
Fluid volume excess
Metabolic acidosis
Hyponatremia
Hyperkalemia
Waste product accumulation
Neurologic disorders
AKI happens
1 day after hypotensive event and can last 1-3 weeks
Chronic Kidney Disease: 6 stages
The stages are determined by GFR in mL/min
Stage one and two = No symptoms
Moderates stages = Hypertension
Severes stages = Other clinical manifestations (stage 5 = Uremic)
Best way to treat chronic kidney disease
Prevent by controlling the things that cause it
Most common caused of CKD
Diabetes - 50%
HTN - 30%
Glomerulonephritis - 10%
Other - 10%
Risk Factors for CKD
Family history
Increasing age > 60
Male
Black / African American
HTN, DM, Smoking
Overweight and obesity
CKD: Pathogenesis
PP slide
What indicates worsening chronic kidney disease
Increase in angiotensin II
Proteinuria
Watch blood pressure and monitor urine of these patients
CKD Manifestations
Neurologic
Cardiovascular
Gastrointestinal
Integumentary
Cardiovascular Manifestation of CKD
HTN
CAD
Pericarditis
PAD
Neurological Manifestations of CKD
Fatigue
Headache
Sleep disturbances
Encephalopathy
Gastrointestinal Manifestations of CKD
Anorexia
Nausea
Vomiting
GI bleed
Gastritis
CKD: Manifestations: No longer maintains F & E Homestostatis
Edema (third spacing) (FVO)
Hyperkalemia
Hyperphosphatemia
Hypermagnesemia
Metabolic acidosis
CKD manifestations: No longer rids the body of wastes via urine
Anorexia (lack of appetite)
Malnutrition
Itching (frost)
CNS changes
CKD manifestations: Decreased erythropoietin
anemia
