Chapter 34: AKI and CKD Flashcards
Acute Renal Injury
decreased GFR, decreased waster removal, inability to egulate fluid, electrolytes, and pH balance
Azotemia
increased blood concentration of nitrogenous wastes (urea, nitrogen, uric acid and creatinine)
Prerenal AKI
associated with decreased renal blood flow
most common type
Causes of Prerenal AKI
hypovolemia dehydration burns distributive shock (sepsis, anaphylaxis) HF and cardiogenic shock post-MI renal stenosis
Intrarenal AKI
associated with renal ischemia, toxins or tubular obstruction
Causes of Intrarenal AKI
acute tubular necrosis
exogenous nephrotoxins (aminoglycosides, heavy metals, ethylene glycol)
endogenous nephrotoxins (myoglobin, uric acid, Hgb)
inflammatory conditions
Acute Tubular Necrosis
death of epithelial cells that line the renal tubules
once dead, the cells are released into the tubular lumen causing obstruction
Postrenal AKI
associated with the obstruction of urine outflow out of the kidneys
Causes of Postrenal AKI
ureteral calculi ureteral strictures bladder tumors spinal cord injuries BPH
Prerenal BUN:Cr
BUN:Cr ratio is higher than normal (>20:1)
urine has high osmolality (low Na)
Intrarenal BUN:Cr
BUN: Cr ratio is lower lower than normal (<10:1)
urine has low osmolality (urine Na high)
Onset of Acute Renal Failure
increased urinary excretion of Na = hyponatremia
Chronic Kidney Disease
slow, progressive inability of the kidneys to respond to changes in body fluids and electrolyte composition w/ an inability of the kidneys to produce sufficient urine
________ is essential in those with advanced kidney disease.
Restriction of protein
Uremia
term used to describe the clinical manifestations of CKD
