Chapter 34 Flashcards
a condition in which the kidneys fail to remove metabolic end products from the blood and regulate the fluid, electrolyte, and pH of the extracellular fluids
renal failure
when the kidneys fail…
less waste is removed, more waste remains in the blood, nitrogenous build up in the blood
bun normal value:
5-25
bun rise reflects
a decrease in renal function (sometimes)
creatinine normal value
.5-1.5
with creatinine, high is a problem… but low is
NOT
creatinine is a reflection of
GFR and is a better indicator of renal function
sudden, rapid onset. often reversible. abrupt reduction on renal function
acute
chronic, slow progressing to end-stage renal failure. over months or years. not reversible.
chronic
three types of acute kidney injury
- prerenal
- intrinsic
- postrenal
usually progressive, generally not reversible. detoriation of kidney function.
chronic renal failure
chronic renal failure involves
tissue destruction, loss of kidney function, and eventual end stage renal disease
possible causes of CKD
chronic glomerular disease, chronic UTIs, obstructions, cancers, autoimmune functions, diabetes, vascular disases
development of CRF:
- diminished renal reserve
- renal insufficency
- renal failure
- end-stage renal disease
nephrons are working as hard as they can. losing numbers
diminished renal reserve
nephrons can no longer regulate urine density, electrolytes are wack, starting to notice problem, work until they can’t.
renal insufficency
renal failure starts when
nephrons can no longer keep blood composition normal. RAAS kicks in, high blood pressure. leading to sclerosis.
cardiovascular consquences of CRF
- decrease viscosity
- increased blood pressure
- decreased oxygen supply
process of cardiovascular consquences of CRF:
less erythropoietin –> anemia –> lower blood viscoity –>blood flows though vessels more swiftly –> heart rate increases—> increased workload on left heart –> left ventricle dilation and hypertrophy –> not enough 02 to support LV function —> angina ischemia/LHF!!!!!!
CKD: what would occur?
- HTN and CV: hypervolemia (too much fluid)
- Peripheral edema: fluid and protein issues
- ALT in H20, electrolyte, acid-base balance (hyperkalemia)
- anemia: no erythropoetin
- mineral and skeletal disorders: hyperphosphatemia (not eliminating, can cause weak by pulling calicum)
- accumulation of nitrogenous waste products
- fluid and electrolyte balance: Na and H20 balance, K+ balance, acid base balance (metabolic acidosis when GRF is 30-40%), calicum/phosphate/bone
- problems with proteins, carbohydrates, fat metabolism
- anemia
CKD affects all system. List how it affects each system:
- Renal: fatigue, decreased urine.
- cardiovascular: HTN, heart failure, life threatening arrhythmias
- Gi: nausea, gum sores, abnormal pain
- skin: pallid, yellowish-brown color, dry/itchy/scaly skin
- impaired platelet function: bruising
- neurologic: LOC, muscle cramps, pain, itching and burning
- endocrine
- musculoskeletal: bone fractures and muscle pain
CKD and its treatment can interfere with
absorption, distribution and elimination of drugs
altered metabolism results of
less protein bound drugs and increased intermediates of drug metabolism
