Chronic Renal Disease Flashcards
What is uremia?
toxicity due to waste product accumulation in the blood
Chronic kidney disease (CKD) is defined as _______.
a permanent reduction in glomerular filtration rate (GFR)
Why does HTN occur in CKD?
- increased ECF volume
- increased RAAS
- ANS dysfunction–> insensitive baroreceptors
- diminished vasodilators
How does the kidney compensate for decreased nephrons and H+ balance?
NH4+ production is increased to keep acid balance normal until GFR falls below 20 –> then a non-anion gap metabolic acidosis can occur
Name the 6 most common causes of CKD.
- Diabetic nephropathy- most common
- Hypertensive nephrosclerosis and Renal vascular disease
- Glomerulonephritis
- Polycystic kidney disease
- Interstitial nephritis
- Obstruction
What are the skin disorders associated with uremia?
- pruritus
- hyperpigmentation
- easy bruising
Overproduction of _____ hormone in response to hypocalcemia and _____ hormone in response to volume overload could contribute to many aspects of the uremic state.
parathyroid…..natriuretic
What are the pulmonary disorders associated with uremia?
- pleuritis
- pulmonary edema
What are the hemotologic disorders associated with uremia?
- anemia
- bleeding tendency
What happens to sodium balance in CKD?
flexibility is lost- kidneys can’t appropriately adjust to changes in solutes and water
How are creatinine and urea balanced in CKD?
they are kept proportional but in elevated amounts
Do CKD pts have excess water or decreased water in the plasma?
they’r susceptible to both
Decreased ______ of vitamin D contributes to bone disease and secondary hyperparathyroidism.
1-hydroxylation
What are the cardiovascular disorders associated with uremia?
- pericarditis
- hypertension
- congestive heart failure
- coronary artery disease
- vascular calcification
What are the psych disorders associated with uremia?
- depression
- anxiety
What are the Fluid and Electrolyte disorders associated with uremia?
- edema
- hyponatremia
- hyperkalemia
- hypermagnesemia
- metabolic acidosis
- volume expansion or depletion
Decreased 1-hydroxylation of ______ contributes to bone disease and secondary hyperparathyroidism.
vitamin D
What are the metabolic-endocrine disorders associated with uremia?
- glucose intolerance
- hyperlipidemia
- hyperuricemia
- malnutrition
- sexual dysfunction
- infertility
Decreased 1-hydroxylation of vitamin D contributes to _____ and _______.
bone disease; secondary hyperparathyroidism
Progression of chronic kidney disease is prevented by the administration of ______ or _____.
converting enzyme inhibitors…. angiotensin receptor blockers
What are the GI disorders associated with uremia?
- anorexia
- nausea
- vomiting
- gastroenteritis
- gastrointestinal bleeding
Why does anemia occur in CKD?
- decreased EPO
- shortened RBC lifetime
- decreased platelet function and blood loss
- marrow space fibrosis
What are the neurological disorders associated with uremia?
- encephalopathy
- peripheral neuropathy
How does potassium balance change in CKD?
plasma and total body K are maintained, but hyperkalemia can occur with sudden dietary K loads
What is the primary regulator of PTH?
calcium
What are the bone/Ca++/PO4- disorders associated with uremia?
- hyperphosphatemia
- hypocalcemia
- dystrophic calcification
- secondary hyperparathyroidism
- 1,25-dihydroxy vitamin D3 deficiency
- osteomalacia
- osteitis fibrosa
