EXAM 3 Flashcards
ANURIA
O urine
Acute renal failure
BUN
Increase number of cells in the prostate; urination retention,; sign of renal failure OR dehydration, cause urinal overload,
Acute-post renal failure
Creatinine
A normal creatinine. 1.2 or less the higher the worst the kidney function
High creatinine clearance is good kidney function
The Highre the GFR the better the kidney function
Dialysis
A treatment to filter the blood.. the machine acts like the kidney.
Halitosis
Bad breath; too much toxins building up from acute renal failure
Intrarenal
Inside of the kidney is starting to be damage and lead to renal failure. Damage to kidney itself
Medication and infectious process can occcur
Nephrolithiasis
Kidney stones; leads to kidney failure.. causes post renal failure
Nephrotoxic
Something that cause damage. To the kidneys
Medications, Motrin, antibiotics.
Oliguria
A low urine output
<30 ml and its 400 ml or less
Polyuria
Increase urinationhappens in diabetics
Pre-renal
Hypovelemic shock.. something that prevent kidneys form getting blood flow;
decrease effective blood flow to the kidney and cause a decrease in the glomerular filtration rate (GFR). Both kidneys need to be affected as one kidney is still more than adequate for normal kidney function.
Post-renal
Not common; Results from obstruction of urine outflow from the kidneys • Calculi, strictures, bladder tumors, BPH (most common) • Treat the underlying cause of obstruction
Puritis
Happens with itching of the skin; accute renal failure.
Glands of the Endocrine system
Pituitary, thyroid, parathyroid, adrenal glands
Organs that produce hormones
Pancreas, gonads, hypothalamus
Hormones
Help regulation in the body. -regulate water and electrolytes -respond to adverse conditions like infections -help with growth and development - reproduction - pregnancy maintenance -digestion -nutrient storage Hypothalamus release these hormones There are Paracrine hormone and Autocrine hormones
Paracrine
Paracrine hormone produces action LOCALLY on other cells
Autocrine
Produces action on the cells from which they were produced
Renal Agenesis
No kidney formation; there are two types of renal agenesis
- bilateral: no kidney formation and baby dies within a couple of days
-unilateral: there is one kidney that hasn’t developed; only have ONE kidney. Lead to hypertrophy.
Usually we know when a baby has no kidney or one kidney before birth because of psychographs. But unilateral are usually discovered by accident, once the patient is experiencing renal failure.
Renal Hypoplasia
Kidneys are small in size. They can be bilateral or unilateral.
Renal Dysplasia
is a condition in which one or both of a baby’s kidneys develop abnormally in the womb, often causing cysts (fluid-filled sacs) to replace normal kidney tissue. /A lot of cysts that develop within the kidneys that leads to destroying the inside of the kidney.
S/S HTN, develop a Wilms tumor (tumor within the kidneys)
Hvae to do a sonogram to see how the kidneys are functioning. And monitor blood pressure
Cystic Diseases of the kidney
Can be multiple, vary in size; can be affect a person or not (symptomatic or asymptomatic), acquired or hereditary
Ex: autosomal dominant polycystic kidney disease, autosomal
recessive polycystic kidney disease, nephronophthisis, medullary
cystic disease
Autosomal dominant polycystic kidney disease
Develop later in life. Usually its unilateral.Most common inherited kidney. Disease. Multiple expanding cysts destroy kidney structure and cause renal
failure
Manifestations: pain, hematuria, UTI’s and HTN
Use CT scans to diagnose
-contttrol pain UTI and BP
Autosomal recessive polycystic kidney disease
This is a childhood disease; usually present at birth and progresses rapidly.
It’s B/L (bilateral), masses on kidneys and lower back, impaired lung development, HTN and they are most likely to die before they can leave the hospital.
Nephronophthisis
Occurs in children;
-small kidneys, multiple cysts, progresses to CKD (Chronic kidney disease), and causes polyuria (excessive urination), polydipsia ( abnormally great thirst), enuresis (bed wetting)
Polyuria
Excessive urination
Polydipsia
Extreme abnormal thirst
Enuresis
Bed wetting
Medullary Cystic Kidney Disease
Occur in adults, chronic kidney disease, small kidneys, polyuria, polydipsia, enuresis.
Simple and Aquired renal cysts
These are the ones that dont really affect the patient or then can cause symptoms. If they doo cause symptoms, its usually gonna cause flank pain (lower back pain), hematuria (urine in the blood), urinary tract infection and HTN. Common in people over 50. Use US (ultrasound) CT scan to. Diagnose.
Acute Nephrotic Syndrome
An inflammatory response that occurs when a patient is experiencing an infection (SLE ‘Systemic Lupus) or it occurred after an infection
S/S: sudden onset of hematuria (blood in urine), proteinuria (protein in urine), decreased GFR (glomerular filtration rate), oliguria (the production of abnormally small amounts of urine.), edema, HTN
Oliguria
the production of abnormally small amounts of urine.
40ml or less
glomerular filtration rate (GFR)
is a blood test that checks how well your kidneys are working. Your kidneys have tiny filters called glomeruli. These filters help remove waste and excess fluid from the blood. A GFR test estimates how much blood passes through these filters each minute.S
Hematuria
Blood in urine
Proyeinuria
Protein in urine.
Acute post infectious glomerulonephritis
Develop this after a strep infection(strains of group A beta-hemolytic streptococci) ,( 7-10 days post-infection.
Its rare in the U.S.
SS: oliguria, hematuria, edema (especially face and hands), HTN
Treatment: antibiotics (ABX), supportive care and it usually resolves
Acute Pyelonephritis
Caused by E. Coli ; bacterial infection
Common in females. Because of our anatomy.
Uncomplicated- because the person’s renal structure has no abnormality in it. We can treat them less aggressively compared to ones who is more complicated.
Acute onset: shaking, chills, fevers, constant pain in groin and lower back and its usually on one side (unilateral), dysuria (difficulty or painful urination), urgency to pee
-treatment: antibiotic for 10-14 days.
Renal Failure
Has two diff. Components : acute or chronic
Acute Kidney injury (AKI) or Chronic Kidney Disease (CKD)
When the kidneys fail to remove metabolic end products from the blood and regulate the fluid, electrolyte and pH balance of the Extracellular fluid
Acute Kidney Injury (AKI)
If we can find out why the patient has acute renal failure, we can treat it immediately and reverse it if recognized early
- abrupt decline within 48hours in kidney function, fluid and electrolyte balance is disrupted.
-25-80% mortality rate, depending on the cause.
-increase creatinine, reduced urine production
-can be caused by blood clot in artery/obstruction and lead to decrease blood flow without ischemic injury. Taking meds can cause AKI
There are three types of acute renal failure:
1. Prerenal
2. Intrarenal
3. Post renal
Prerenal and intrarenal account for 80-90% (common)
BUN/Cr: BUN 8-20, cr <1.2 Kidney biopsy (we try to avoid this)
S/S: decreased urine output, fluid retention (edema, pulmonary congestion), HTN,
If untreated, it causes neuromuscular irrability, somnolent (sleepy and drowsiness), coma and death.
Chronic kidney disease (CKD)
Develops over the course of the years; irreversible damage and can lead to dialysis.
Decline of renal function in 3months or more.
Causes: HTN, DM, SLE (Systemic lupus erythematosus)
Check GFR
S/S: early stages are asymptomatic, as it progresses fluid,
electrolyte and acid-base disturbances, hyperkalemia, HTN,
anemia
AKI Prerenal Injury
Most common; Prerenal means that the kidneys are not gettin adequate blood flow, that means that they can’t work correctly and go into failure
/Most common, characterized by marked decrease in renal
blood flow • Can be reversed if the cause of the decreased blood flow can
be identified and corrected before kidney damage occurs
Causes: depletion of vascular volume, which leads to hypotension, not getting adequate. Blood flow.
Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBS), NSAIDS (Non-steroidal anti-inflammatory drugs)
ELDERLY ARE AT INCREASED RISK
AKI Post Renal injury
Results from obstruction of urine outflow from the kidneys
-like Calculi (kidney stones), bladder tumors, BPH (benign prostatic hyperplasia) BPH IS THE MOST COMMON
AKI Intrarenal Kidney Injury
Damage to the kidneys ITSELF
Ex: infections, DM (every time blood sugar goes up, causes damage to blood vessels), glomerulonephritis, nephrotoxic substances.
Immunity
Protection from infectious disease