Chapter 34: Medical Therapy for Renal Disorders Flashcards
ultrafiltrate
A fluid produces by the kidney. Further processing of the ultrafiltrate creates urine
vasopressin aka antidiuretic hormone (ADH)
A small peptide hormone secreted by the posterior pituitary, which is also called antidiuretic hormone (ADH)
oliguri
Urinary volume of less than 500 mL/day
creatinine (Cr)
A nitrogenous waste present in urea
azotemia
If normal waste products are not eliminated appropriately, they collect in abnormal quantities in the blood
renal failure
The inability to excrete the daily load of wastes
renin-angiotensin mechanism
A major control of blood pressure
erythropoietin (EPO)
A hormone produced by the kidney. It is a critical determinant of erythroid activity in the bone marrow.
nephrolithiasis
A highly prevalent disease worldwide. AKA kidney stones
hyperoxaluria
Occurs when you have too much oxalate in your urine. Oxalate is a natural chemical in your body, and it’s also found in certain types of food. But too much oxalate in your urine can cause serious problems
hypercalciuria
Describes a value of calcium in excess of 300 mg/day in men, 250 mg/day in women
idiopathic hypercalciuria (IH)
A familial disorder characterized by abnormal serum calcium in the absence of known causes of hypercalciuria.
renal tubular acidosis (RTA)
An acidosis accompanied by hypokalemia
acute kidney injury (AKI)
Characterized by a sudden reduction in glomerular filtration rate (GFR)
glomerular filtration rate (GFR)
The amount of filtrate per unit in the nephrons, and altered ability of the kidney to excrete the daily production of metabolic waste
blood urea nitrogen (BUN)
A measure of how well the kidneys are working
renal replacement therapy (RRT)
Replaces nonendocrine kidney function in patients with renal failure and is occasionally used for some forms of poisoning.
hemodialysis (HD)
Procedure where a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean your blood.
continuous renal replacement therapy (CRRT)
CRRT is done 24 hours a day to slowly and continuously clean out waste products and fluid from the patient. It requires special anticoagulation to keep the dialysis circuit from clotting.
continuous venovenous hemofiltration (CVVH)
A temporary treatment for patients with acute renal failure who are unable to tolerate hemodialysis and are unstable.
continuous venovenous hemodialysis (CVVHD)
An effective treatment of choice applicable to all critically ill unstable patients
chronic kidney disease (CKD)
The progressive loss of function of the kidneys
estimated glomerular filtration rate (eGFR)
An estimate of the rate at which the kidneys are filtering waste
angiotensin-converting enzyme (ACE)
A group of blood pressure medications
angiotensin II receptor blockers (ARBs)
A group of medication used in treatment of chronic kidney disease
kidney dialysis outcome quality initiative (KDOQI)
Establish national renal guidelines
kidney disease improving global outcomes (KDIGO)
Establish international renal guidelines
phosphate binders
A group of medications often used in treatment of chronic kidney disease
end-stage renal disease (ESRD)
Reflects the kidney’s inability to excrete waste products, maintain fluid and electrolyte balance, and produce certain hormones
fistula
A surgically created connection between an artery and a vein
graft
An artificial vessel that may be implanted surgically
dialysate
A nonsterile aqueous electrolyte solution that is similar to the normal levels of electrolytes found in extracellular fluid with the exception of the buffer bicarbonate and potassium
kinetic modeling
A method for evaluating the efficacy of dialysis that measures the removal of urea from the patient’s blood over a given time period
Kt/V
A formula used to evaluate dialysis. K is the urea clearance of the dialyzer, t is the length of time of dialysis, and V is the patient’s total body water volume
urea reduction ratio (URR)
A method to determine effective dialysis treatment. This method looks at the reduction in urea before and after dialysis
protein-nitrogen appearance (PNA) rate
Compares to a simplified nitrogen balance study in the dialysis patient.
renal osteodystrophy
A metabolic bone disease categorized into four types: osteomalacia, osteitis fibrosa cystica, metastatic calcification, or adynamic (low-turnover) bone disease
osteomalacia
Softening of the bones, typically through a deficiency of vitamin D or calcium
osteitis fibrosa cystica
A skeletal disorder caused by an overproduction of parathyroid hormone from the overactive parathyroid glands.
metastatic calcification
The deposition of calcium salts in previously normal tissue
adynamic (low turn-over) bone disease
A histological condition found in uremic patients. It is characterized by low bone resorption and formation, and, in contrast to osteomalacia, the amount of osteoid tissue is normal or low.
calciphylaxis
Occurs when calcium phosphate is deposited in wound tissues with resultant vascular calcification, thrombosis, nonhealing wounds, and gangrene
recombinant human EPO (rHuEPO)
A synthetic form of EPO used to treat the anemia of chronic renal failure
intradialytic parenteral nutrition (IDPN)
Can be administered to support a patient’s nutritional status. Administered typically through a connection to the venous side of the extracorporeal circuit during dialysis
intraperitoneal nutrition (IPN)
A method of nutrition support for peritoneal dialysis patients. This method uses a peritoneal dialysate solution that contains amino acids instead of dextrose
