Alterations of Kidney Function Flashcards
Define Hydronephrosis
Fluid accumulation around the kidneys due to inability of urine to drain properly
Causes increase in hydrostatic pressure and decrease in GFR
What are the possible complications of a chronic partial kidney obstruction?
Failure to concentrate urine can cause dehydration and metabolic acidosis
What are the three types of kidney stones?
Calcium oxylate (80%) Struvite (15%) Uric acid (7%)
Which kidney stones are often precipitated by infection and more common in women?
Struvite stones
What increases risk for kidney stones?
High urinary concentration of stone forming substances
pH, low urine output, tubular defects
medication, regional enteritis and ulcerative colitis
What are staghorn calculi?
Large kidney stones
What are the S&S of kidney stones?
Colicky, flank or radiating groin pain
N&V, hematuria
What is lithotripsy used for?
The breakdown of kidney stones for easier voiding
What causes neurogenic bladder?
Interruption of nerve supply to bladder. Usually CNS or spinal cord trauma
What are the S&S and complications of a neurogenic bladder?
frequency of voiding, overflow incontinence
Risk of infection from incomplete bladder emptying /urine pooling
What are renal tumors often associated with?
tobacco use, obesity and analgesic use
What are the signs and symptoms of renal tumors?
Hematuria, flank pain, palpable flank mass and weight loss.
Early stages asymptomatic besides some hematuria
How are renal tumors treated?
Cytoscopy and chemotherapy
What are the risks for UTIs?
Premature infants, sexually active and pregnant women, women on antibiotic disrupting vaginal flora, spermicide users, indwelling catheters, UT obstruction
What is the most common UTI?
cystitis
What is the most common UTI?
cystitis
What is the most common UTI?
cystitis
What is the most common UTI?
cystitis
What is the most common UTI?
cystitis
What is the most common UTI?
cystitis
What are the S&S of cystitis?
Dysuria, frequency, urgency, pain, hematuria
What is pyelonephritis?
Infection of renal pelvis and interstitium
What are possible causes of pyelonephritis?
Infection (bacterial, viral or fungal), kidney stones, pregnancy, neurogenic bladder and female sex trauma
What is the pathology of acute pyelonephritis?
- Spread via ureters or bloodstream
- infection causes infiltration of WBC with renal inflammation and purulent urine
- Release of phagocytic lysozymes etc. may damage tubular cells
- Healing involves scar tissue and atrophy of affected tubules
How is
How is acute pyelonephritis diagnosed/treated?
Urine culture
2 weeks of microorganism specific antibiotics
What are possible complications of chronic pyelonephritis?
Obstruction and inability to eliminate bacteria causes destruction of tubules
Can lead to CRF
Fibrosis and scarring, dilation of renal pelvis and calyces and atrophy of tubules
What is glomerulonephritis?
Inflammation of glomerulus cause by immunologic abnormalities (most frequently), drugs/toxins, vascular disorders, systemic disease
Define end stage renal failure
When kidneys cease functioning on a permanent basis leading to the need for a regular course of long-term dialysis or a kidney transplant to maintain life
What is the onset of acute glomerulonephritis
Onset of 7-10 days
Symptoms 10-21 days post infection
What is the most common cause of CRF and ESRD?
Glomerulonephritis
What is the patho of glomerulonephritis?
Deposition of circulating soluble complexes
Formation of antibodies against glomerular basement membrane eventually forming growth
Streptococcal release of neuraminidase (enzymes) furthering complications
What are the S&S of glomerulonephritis?
Hematuria with RBC casts (brown to red/pink), proteinuria (exceeding 3-5g/day)
Renal insufficiency after 10-20 years
What denotes renal insufficiency?
loss of up to 25% of renal function or GFR of 25-30 ml/min. Increased serum creatine and urea
What amount of renal function is available during end stage renal disease?
Less than 10%
Define azotemia
increased serum urea levels and frequently increased creatine levels in the blood
What is urea?
increased urea and creatine, fatigue, anorexia, N&V, pruritus, neurologic changes and edema
What are possible causes of acute renal failure?
severe hypotension, vascular obstruction, severe glomerular disease and squela to radioactive media
Ischemia (blood loss during surgery, sepsis, severe burns or trauma)
What is the treatment goal for acute renal failure?
TO maintain life until renal function resumes (dialysis)
Why can ischemia cause acute renal failure?
Ischemia generates toxic oxygen free radicals and inflammatory mediators causing swelling, injury and necrosis
What is chronic renal failure
Progressive and irreversible loss of renal function
>25% loss of renal function
How is chronic renal failure diagnosed?
Blood values (BUN, creatine), ultrasounds, IVP, renal biopsy and symptoms
How is chronic renal failure treated?
Diet, sodium and fluids, caloric intake, erythropoietin, dialysis or transplant
What are possible causes of chronic renal failure?
Type II diabetes, chronic hypertension, long lasting viral illnesses (HIV, Hep B and C), chronic glomerulonephritis, chronic pyelonephritis
What are S&S of chronic renal failure
Usually asymptomatic until too late
High BP, N&V, anorexia, fatigue and weakness, sleep issues, peripheral edema and possibly chest pain and shortness of breath
