CKD AND AKI Flashcards
What does the glomerulus do
- Specialised unit of blood capillaries that does the filtration
- Capillaries have fenestrations that do the filtration such as water and ions nut not large things
What are the functions of the Kidney and what happens if CKD is present?
- Reabsorption of nutrients- amino acid and glucose
- Hormone synthesis- renin and erythropoietin
3.Excretion of waste products- urea and creatinine
4.pH regulation - Metabolism of drugs and hormones- Insulin
6.Regulation of body water and salt content- ADH and reabsorption of water
The opposite of everything
what is the link between Cardiovascular disease and CKD
- Cardiovascular disease (CVD) cause 40 – 50%deaths from End-stage renal disease (ESRD
- Lower Glomerular Filtration rate (GFR) and high albumin excretion independent risk factors CVD
- if the kidney is damaged the phosphate is high which means it is leading to cardiovascular disease.
What is the difference between CKD and AKI?
- CKD - slow onset greater than 3 months and irreversible but progress into more severe stages can be slowed with treatment
- AKI- Rapid for hours to days and is reversible but damage can lead to CKD
What are the causes of CKD?
- 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 - 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.
What is hypocalcemia?
Less activated vitamin d so less calcium is absorbed in the blood resulting - low calcium levels release parahyroid hormone making bone weak
What are the different types of CKD
Diabetic nephropathy
Glomerulonephritis
Polycystic kidney disease
Hypertension
Chronic pyelonephritis
Renal vascular disease
what is Diabetic nephropathy
- Damage to renal arterioles and glomerulus due to exposure to high circulating glucose concentrations
- Develops slowly
- Observed as an increase in urine albumin excretion to between 30 and 300 mg/day, indicating glomerular damage,
What is Glomerulonephritis?
- Immune complex deposits in glomerulus - inflammation
- exist in HIV
- Antibodies in your blood can stick together and be deposited in your kidney.
What is Polycystic kidney disease?
- A genetic disease which is not on the X chromosomes
- 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 - child one has a mutation or gene on the chromosome 6
What is Chronic pyelonephritis
Tubulointerstitial inflammation - scarring
Destruction of nephrons
What is Renal vascular Disease?
- 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
How does azotemia happen
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
what is the ml of cod
90ml/min/1.73
What is treatment is available for CKD
Dialysis and kidney transplant