Ch. 30 Renal - Book/3 Flashcards
struvite stones primarily contain
3
- magnesium
- ammonium
- phosphate
CKD decreases what
2
- GFR
2. tubular functions
CKD is the
progressive loss of renal function associated with systemic disease
moderate or severe pain often originating in the flank and radiating to the groin
renal colic
urinary stone dx test
24 hour urine to identify which stone and pH test
colic that radiates to the lateral flank or lower abdomen typically indicates
obstruction of the midureter
renal colic usually indicates
obstruction of the renal pelvis or proximal ureter
most common stone types
4
- calcium oxalate or phosphate
- struvite
- uric acid
- cystine (rare)
angiotensin II promotes
glomerula HTN and hyperfiltration caused by efferent arteriolar vasoconstriction and promotes systemic HTN
contributes to tubulointersitial injury by accumulating int he interstitial space of the nephron tubule and activating complement proteins and other mediators and cells
proteinuria
two systemic issues associated with calcium stones
- hyperparathyroidism
2. bone demineralization
calculi can be located in the
3
- kidneys
- ureters
- urinary bladder
uremia and azotemia is to
CKD
dilation of the upper urinary tract is an early response to
obstructions
proteinuria contributes to
tubulointersitial injury by accumulating int he interstitial space of the nephron tubule and activating complement proteins and other mediators and cells
usually indicates obstruction of the renal pelvic or proximal ureter
renal colic
kidney stones aka
calculi
urinary stones
risk of urinary calculi formation is influenced by
8
- age
- sex
- race
- geographic location
- seasonal factors
- fluid intake
- diet
- occupation
kidney damage defined as GFR at
<60 ml/min for 3 months or more
renal stone - acidic urine
increases the risk of uric acid stone formation
what is associated with calcium stones
7
1. hypercalciuria 2 hyperoxaluria 3. hyperuricosuria 4. hypocitraturia 5. mild renal tubular acidosis 6. crystal growth inhibitor deficiencies 7. alkaline urine
clinical manifestations of CKD
2
- uremia
2. azotemia
the chronically high intraglomerular pressures increases
glomerular capillary permeability, contributing to proteinuria
dilation of the renal pelvic and calyces proximal to blockage is referred to as
hydronephrosis/ureterohydronephrosis
uric acid stone formation is affected by consumption of
purines (meat and beer) in diet
renal stone - alkaline urine
increases the risk of calcium phosphate stone formation
renal colic
moderate or severe pain often originating in the flank and radiating to the groin
two factors that have been recognized to advance renal disease
- proteinura
2. angiotensin II activity
CKD - intact nephron hypothesis proposes that
loss of nephron mass with progressive kidney damage causes the surviving nephrons to sustain normal kidney function
kidney stones - men vs women
slightly more common in men
renal stone - cystallization is the process by which
crystals grow from a small nidus or nucleaus to larger stones in the presence of supersaturated urine
kidney stones are
masses of crystals, protein, or other substances that are a common cause of UTO in adults
what leads to proteinuria
- glomerular hyperfiltration
- increased glomerular capillary permeability
- loss of negative charge
CKD - tubular interstitial diseases damage primarily the tubular or medullary parts of the nephron, producing problems such as
3
- renal tubular acidosis
- salt wasting
- difficulty diluting or concentrating urine
most renal stones are __lateral
uni
can AKI progress to CKD
yes
CKD - damage is vascular or glomerular, what results
3
- proteinuria
- heamturia
- nephrotic syndrome
calculus formation is related to
4
- supersaturation of one or more salts in the urine
- precipitation of the salts from a liquid to a solid state
- growth through crystallization or agglomeration (aggregation)
- presence/absence of stone inhibitors
CKD systemic diseases include
4
- DM #1
- HTN
- systemic lupus erythematosus
- intrinsic KDs (AKI, chronic glomerulonephritis, chronic pyelonephritis, obstructive uropathies, vascular disorders)
dilation of the ureter is referred to as
hydroureter (accumulation of urine in the ureter)
uric acid stones occur in persons who
excrete excessive uric acid in the urine, such as those with gouty arthritis
CKD - systemic changes result from increased levels of
3
- creatinine
- urea
- potassium
