Chapter 42: acute renal injury and chronic kidney disease Flashcards
Renail Failure
+ Def: a condition in which the kidney fail to remove metabolic end products from the blood and regulate the fluid, electrolyte, and pH balance of the extra-cellular fluids
+underlying causes
- renal disease, systemic disease, urologic defects on non-renal origin
prevention and early diagnosis of acute renal failure
+assessment measures to identify persons at risk for development of acute renal failure
- those with preexisting renal insufficiency and diabetes
- elderly persons (due to the effects of aging on renal reserve)
Types of renal failure
+acute renal failure
-abrupt in onset
-often reversible if recognized early and treated appropriately
+chronic renal failure
-The end result of irreparable damage to the kidneys
-it develops slowly, usually over the course of a number of years
prerenal cases of acute renal failure
- hypovolemia
- decreased vascular filling
- heart failure and cardiogenic shock
post-renal causes of acute renal failure
- bilateral urethral obstruction
- bladder outlet obstruction
phases of ATN
-onset or initiating phase:
+last hours or days
+the time from the onset of the precipitating event until tubular injury occurs
-maintenance phase
+characterized by a market decrease in the GFR
-recovery phase
+period during which repair of renal tissue takes places
common causes of chronic renal disease
- hypertension
- diabetes mellitus
- polycystic kidney disease
- obstructions of the urinary tract
- glomerulonephritis
- cancer
- autoimmune disorders
- diseases of the heart of lungs
- chronic use of pain medication
stages of the progression of chronic renal failure
- diminished renal reserve
- renal insufficiency
- renal failure
- end-stage renal disease (ESRD)
- mild reduction of GFR to 60-89
- moderate reduction of GFR 30-59
- severe reduction in GFR <15 with a need for renal replacement therapy
clinical manifestations of chronic renal failure
- accumulation of nitrogenous wastes
- alterations in water, electrolyte and acid-base balance
- mineral and skeletal disorders
- anemia and coagulation disorders
- hypertension and alterations in cardiovascular function
- GI disorders
- neurologic complications
- disorders of skin integrity
- immunologic disorders
Treatment during the renal insufficiency stage renal failure
-using measure to retard deterioration of renal function and assist the body in managing the effects of impaired function
+ treating urinary tract infections promptly
+avoiding medication with renal damaging potential
+controlling blood sugar in persons with diabetes
+stopping smoking
Target populations comprising persons with chronic renal failure
- persons with chronic renal insufficiency
- persons with renal failure being treated with hemodialysis
- persons with renal failure being treated with peritoneal dialysis
- renal transplant recipients
Factors determining the manifestations of renal failure
- the extent of renal function that is present
- coexisting disease conditions
- the type of renal replacement therapy that the person is receiving
Disorders of water, electrolyte, and acid-base balance
-sodium and water balance
+the kidneys function in the regulation of extracellular fluid volume
-potassium balance
+approximately 90% of potassium excretion is through the kidney
-acid-base balance
+the kidneys normally regulate blood pH by eliminating hydrogen ions produced in metabolic processes and regenerating bicarbonate
hematologic disorders accompanying renal failure (A.C)
+anemia
+coagulopathies
Cardiovascular disorders accompanying renal failure
- hypertension
- heart disease
- pericarditis
