Chronic Kidney disease & Renal Failure Flashcards
What are the Homeostatic functions of the kidneys?
Electrolyte balance
Acid-Base balance
Volume homeostasis
What are the excretory functions of the Kidney?
Nitrogenous waste, hormones, peptides, salt and water, middle sized molecules.
What are the endocrine functions of the Kidney?
Erythropoetin, 1 alpha-hydroxylase vitamin D
What is the role of the Kidney in Glucose metabolism?
Gluconeogenesis, Insulin clearance
What happens when the homeostatic function of the kidney is disturbed?
Increased Potassium & Phosphate.
Decreased, Bicarbonate, pH.
Salt and water imbalance.
Acidosis, Hyponatremia, Volume depletion.
What happens when the endocrine function of the kidney is disturbed?
Decreased Calcium.
Anaemia.
Increased Parathyroid hormone (hyperparathyroidism).
What happens when the excretory function of the kidney is disturbed?
Increased Urea & Creatinine.
Decreased Insulin requirement.
What disease does Kidney failure increase the risk of?
Cardiovascular disease.
Why are some patients confused about their kidney failure, especially when their diabetes has gone away?
Diabetes, over a long period of time can cause kidney failure. However, because they are sustaining more of their endogenous insulin due to kidney failure the diabetes can sort of cure itself.
How does Kidney failure present?
Presentation can be either from the consequences of renal failure or the disease that is causing Renal Failure.
What is the normal creatinine level?
50-110 μmol/L
What is tachypnea?
fast, shallow breaths.
Why would a patient be tachypneic with normal oxygen sats and clear lungs?
you are trying to increase bicarbonate, so you need to shift the equation to the left and to do this you try to drop pCO2 through an increased respiratory rate.
What is the normal range for Urea?
3-7 mmol/L
What is the normal range for Sodium?
135-145 mmol/L
What is the normal range for potassium?
3-5 mmol/L
What is the normal range for haemoglobin?
12-16 g/100ml
What does kidney failure do to salt and and water secretion?
Reduced. This leads to Hypertension, Oedema, Pulmonary oedema.
What can salt and water loss also be a symptom of?
tubulointerstitial disorders - damage to concentrating mechanism, can happen after kidney transplant or obstruction, Hypovolemia may also be the cause.
What happens in acidosis associated with kidney failure?
Reduced excretion of H+ ions,
Retention of acid bases,
K+ leaves cells,
Anorexia, Muscle Catabolism.
What are the causes of hyperkalaemia?
Acidosis, Reduced distal tubule potassium secretion.
What are the symptoms of hyperkalaemia?
Cardiac arrhythmias,
Neural & muscular activity,
Vomiting (body trying to get rid of excess K+).
What changes can be seen on the ECG of a patient with hyperkalaemia and kidney failure?
Peaked T waves, P wave - broadens, reduced amplitude, disappears. QRS widening Heart block Asystole Ventricular tacychardia, fibrilation.
What is the relationship between renal failure, CKD and Cardiovascular disease?
Major predictor of end stage renal failure is CKD, but major outcome for a patient with CKD is cardiovascular disease. a patient with CKD is more likely to die due to cardiovascular disease than renal failure.
