clinical: renal failure

Question 1

describe the characteristics of renal failure

Answer 1

• reduction in GFR

- high creatinine

Question 2

examination findings of acute kidney failure

Answer 2

• low BP e.g. 90/60

- JVP low illustrating dehydration e.g. 0cm

Question 3

describe a blood test of someone with acute kidney failure

Answer 3

• elevated creatinine
• elevated urea
• low GFR

Question 4

what are the causes of pre-renal kidney disease

Answer 4

• due to decreased perfusion of kidneys
• generally low BP
  - bleeding
  - sepsis
  - heart failure

Question 5

what are the causes of renal kidney disease

Answer 5

mainly from acute tubular necrosis which generally arises from pre-renal

• could also be due to rapid progressive glomerulonephritis

Question 6

what is the best test for post-renal acute kidney injury

Answer 6

renal ultrasound

Question 7

examination findings of chronic kidney failure

Answer 7

high blood pressure e.g. 180/90
edema (fluid overload)
elevated JVP

malnutrition
rash (build up urea & phosphate)
pericardial rub

Question 8

why is phosphate elevated in chronic kidney failure

Answer 8

kidneys urinate out phosphate if the kidneys have failed the circulating levels in the blood will increase

Question 9

other than a blood test, what other tests are helpful to confirm diagnosis

Answer 9

renal ultrasound to identify size, CRF = <8cm

Question 10

what is the most likely cause of CKD

Answer 10

diabetes (type 2)

Question 11

what is the best treatment for CKD

Answer 11

treat hypertension

- ACE inhibitor (dilate efferent arteriole)