Disorders of the Kidney Flashcards
What is the purpose of the Kidneys?
waste filtration
reabsorption of sodium and water (and other things)
What are the side products in the kidney?
Urea: protein breakdown (ammonia from amino acids + CO2 = urea)
Uric Acid: nucleic acid breakdown (also part of amino acid)
Creatinine: muscle metabolism product
What is Renal Failure?
kidney failure
will have…Azotemia, Uremia, Impaired kidney function, Hyperkalemia
What is Azotemia?
increased Nitrogen compounds in the blood
*nitrogen is not always a waste
What is Uremia?
nitrogen WASTE in the blood
What are the S/S of impaired kidney function?
fatigue, lethargy, confusion, headache, anorexia, metallic taste in the mouth, nausea, vomiting, diarrhea
What is Hyperkalemia?
high blood potassium (acute renal failure), altered heart rate, heart failure
What is an indication of kidney function?
Uremia
What is Dialysis?
- for kidney failure
- removal of wastes from the blood using diffusion and osmosis
frequency of treatment increases with time and progression of disease
What is Peritoneal Dialysis?
A similar solution to blood plasma is injected and infused into the abdominal cavity for 4-6 hours.
not as common these days
What is Hemodialysis?
blood passes through a machine that removes the wastes
Most common these days
Acute Renal Failure
-occurs suddenly
Causes of Acute Renal Failure:
heart failure, shock, blood loss, urinary tract obstruction, toxins, bacteria, drugs
S/S:
1st stage - decreased urine production
Later Stage - large urine output (kidney cannot reabsorb water)
In Acute Renal Failure why does urine output go from decreased urine production in the 1st stage to Large urine output in the later stage?
because kidney is damaged so much that it cannot reabsorb the water
What is the Diet for Renal Failure?
- increased calories
- restricted protein
- controlled water, Na and K
Chronic renal failure should also include vitamin supplements
Why do you want to restrict protein consumption in Renal Failure?
b/c protein breakdown (ammonia) puts extra burden on the kidney
Why do you want to restrict Na and K consumption in Renal Failure?
-fluid balance… don’t want too much water, Na or K
Chronic Renal Failure
-develops slowly
Causes of Chronic Renal Failure:
-inflammation, artery obstruction (decreased blood flow) in kidney, stones, diabetes, high blood pressure
S/S:
-swelling, high BP, CHF, acidosis, K/Ca imbalance, arrhythmias, nausea, vomiting, diarrhea
What is an alternative to Dialysis?
Kidney transplant
What are the barriers to a kidney transplant?
- not enough supply of kidneys
- advanced age and poor health (not good candidates)
- financial difficulties $$$
What kind of drug to kidney transplant patients have to be put on? What are the side effects of this medication?
- immunosuppressive
- to prevent tissue rejection
Side effects:
-altered nutrition status: nausea, vomiting, diarrhea, glucose intolerance, altered blood lipids, fluid retention, hypertension
food safety guidelines
What are the dietary guidelines for Kidney transplant patients?
- controlled proteins
- Na: generally unrestricted, unless edema and hypertension are present
- K, Ca, and P : generally unrestricted
- Vitamin and mineral supplements
Immunosuppressant drugs can cost up to how much a month?
$2500
on average how much is a single kidney transplant?
$259000
What is Nephrotic Syndrome?
when you have loss of plasma proteins in the urine exceeding 3.0 to 3.5 grams a day
Damage to the glomeruli: increase permeability to plasma protein (protein escapes into the urine)
What are the causes of Nephrotic Syndrome?
infections, diabetes, circulatory disorders
What are the symptoms and consequences of Nephrotic Syndrome?
Swelling (edema): albumin is lost in the urine, fluid shifts from the blood… attributes to ascites
CVD (cardiovascular disease) : urinary loss of proteins that inhibit blood clotting, increase level of plasma protein that favors blood clotting
Other effects: infections (loss of antibodies [antibodies are proteins]), rickets (loss of vitamin D carrier)
What is the recommended diet for Nephrotic Syndrome?
restricted protein, low fat, low Na, vitamin D and Ca supplements
What is albumin?
a protein that retains water
this protein is one that can be excreted by the kidneys
Altered blood lipids lead to high risk of ….
CVD
What are kidney stones made of?
could be made of crystalized….
Ca-oxalate, uric acid, cysteine or Mg compounds
What are the possible causes of kidney stones?
dehydration or low urine volume (favors crystallization)
Uric Acidity: some stones form readily in acidic or alkaline conditions
Metabolic Factors and Renal Disease : calcification of tissue and phosphate accumulation (too high minerals)
Genetics: if parents suffer from kidney stones, you will have a high chance of suffering as well
What is the main symptom of kidney stones?
renal colic (severe pain as stones pass through the ureter…if it can pass through the ureter)
What is the treatment of kidney stones?
high fluid intake, surgery, lithotripsy (ultrasound)
What is the recommended diet for those who suffer from kidney stones?
increased fluid, normal Ca, low uric acid and oxalate, no vitamin C megadoses, restricted Na
Why don’t you want to take vitamin C megadoses when you suffer from kidney stones?
because vitamin C increases oxalate solubility
What are food that are high in oxalate? (ones you need to stay away with when you have kidney stones)
green beans, celery, green, eggplant, legumes, okra, sweet potatoes, spinach, squash, soybeans, berries, grapes, chocolate, coffee, beer, grits, nuts, pepper, tea
