CKD AND AKI Flashcards

1
Q

What does the glomerulus do

A
  1. Specialised unit of blood capillaries that does the filtration
  2. Capillaries have fenestrations that do the filtration such as water and ions nut not large things
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2
Q

What are the functions of the Kidney and what happens if CKD is present?

A
  1. Reabsorption of nutrients- amino acid and glucose
  2. Hormone synthesis- renin and erythropoietin
    3.Excretion of waste products- urea and creatinine
    4.pH regulation
  3. Metabolism of drugs and hormones- Insulin
    6.Regulation of body water and salt content- ADH and reabsorption of water
    The opposite of everything
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3
Q

what is the link between Cardiovascular disease and CKD

A
  1. Cardiovascular disease (CVD) cause 40 – 50%deaths from End-stage renal disease (ESRD
  2. Lower Glomerular Filtration rate (GFR) and high albumin excretion independent risk factors CVD
  3. if the kidney is damaged the phosphate is high which means it is leading to cardiovascular disease.
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4
Q

What is the difference between CKD and AKI?

A
  1. CKD - slow onset greater than 3 months and irreversible but progress into more severe stages can be slowed with treatment
  2. AKI- Rapid for hours to days and is reversible but damage can lead to CKD
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5
Q

What are the causes of CKD?

A
  1. Hypertension- thick walls narrow lumen, less blood and oxygen get to the kidney the macrophages get into the damaged glomerus and secrete growth factors which cause mesangials cells to regree back to mesangoblast which secretes extracellular structural matrix which leads to scarring
    2.Nsaids
    3.Hiv
    4.Lupus
    5.Tobacco
  2. diabetes- excess glucose sticks to the proteins which is non-ezymatic glycation this effects the efferent arteriole causes it be stiff and narrow making it hard for blood to leave.
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6
Q

What is hypocalcemia?

A

Less activated vitamin d so less calcium is absorbed in the blood resulting - low calcium levels release parahyroid hormone making bone weak

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7
Q

What are the different types of CKD

A

Diabetic nephropathy
Glomerulonephritis
Polycystic kidney disease
Hypertension
Chronic pyelonephritis
Renal vascular disease

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8
Q

what is Diabetic nephropathy

A
  1. Damage to renal arterioles and glomerulus due to exposure to high circulating glucose concentrations
  2. Develops slowly
  3. Observed as an increase in urine albumin excretion to between 30 and 300 mg/day, indicating glomerular damage,
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9
Q

What is Glomerulonephritis?

A
  1. Immune complex deposits in glomerulus - inflammation
  2. exist in HIV
  3. Antibodies in your blood can stick together and be deposited in your kidney.
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10
Q

What is Polycystic kidney disease?

A
  1. A genetic disease which is not on the X chromosomes
  2. Have a Mutation or PKD1 gene on chromosome 16
    3.Code for proteins that regulate fluid flow in tubular epithelial cells
    4.Asymptomatic to start with, pain and haematuria on kidney enlargement starts at age 40-60yrs
    5.They’re important for structures on cells called cilia, They are very important in the kidney as they regulate the fluid flow in the tubules
  3. child one has a mutation or gene on the chromosome 6
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11
Q

What is Chronic pyelonephritis

A

Tubulointerstitial inflammation - scarring
Destruction of nephrons

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12
Q

What is Renal vascular Disease?

A
  • Narrowing of arteries to one or both kidneys
  • Multiple causes including cardiovascular disease, which is both cause and consequence of CKD
  • Increase risk with age, if female,atherosclerosis, high BMI, smoker, highcholesterol, diabetic
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13
Q

How does azotemia happen

A

Urea gets excreted in the urine decrease gfr means the urea is accumlated in the blood causing azotemia leading is loss of appetite and further lead to coma and death and also bleeding with less clot formation

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14
Q

what is the ml of cod

A

90ml/min/1.73

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15
Q

What is treatment is available for CKD

A

Dialysis and kidney transplant

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16
Q

What are the 4 functions of the nephron

A

filteration
Reabsorption
-secretion
-excertion

17
Q

What happens AKI

A

Rapid loss of renal function
* Retention of urea, creatinine
* Rapid decrease in urine output

18
Q

What are one of the factors to show AKI

A

cretintine

19
Q

Who is at risk of AKI

A

Elderly
* Diabetes
* Hypertension or vascular disorders
* People already diagnosed with CKD
* Dependent on cause, can sometimes bereversed, sometimes will result in CKD

20
Q

What is pre-renal and what are the causes

A

Decrease in blood flow to kidney – renal hypoperfusion

hypotension
* burns
* fluid loss, bleeding-
Vomiting
cardiac failure

rememeber- pre-renal is things before kidney it is reversible

21
Q

What are the bio chemical changes of the pre-Renal?

A

Renal tubular function is normal, but the lowGFR results in the production of a small volumeof highly concentrated urine

low GFR  increased plasma urea andcreatinine.

22
Q

What is intrinsic and what are is causes

A

Happens during the kidney process
Caused by Acute blood loss in trauma,Nephrotoxins and renal ischaemia

23
Q

What are there instrinsic biochemical changes?

A

Increased urine Na concentration
high mortality in urine

24
Q

What is the post renal and what are the causes?

A

Obstruction to the flow of urine – leads to an increase in hydrostatic pressure, leading to secondary renal tubular damage

causes:Stones, cervix cancer, prostate enlargement