general renal cards Flashcards
what are the rules on metformin and eGFR?
review metformin dose if eGFR under 45
stop metformin if eGFR below 30
prescribe with caution with rapid change in eGFR
what are the effects of trimethoprim on the kidney system?
increases risk of hyperkalaemia
interferes with tubular creatinine secretion, causing a rise in creatinine levels and may result in a ‘false positive’ diagnosis of AKI.
what happens in proximal tubule dysfunction and why?
PCT is responsible for resorption of glucose, amino acids, and bicarb (as well as water and potassium)
proximal renal tubule dysfunction (renal tubular acidosis: glucosuria, aminoaciduria, acidosis (due to loss of bicarb)
how does furosemide work?
inhibiting the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle, by binding to the chloride transport channel, thus causing sodium, chloride, and potassium loss in urine.
when is PTH secreted and what does it do?
secreted when there’s hypocalcaemia, increases calcium in blood
what are the causes of polyuria?
diuretic agents
reduced ADH secretion -cranial diabetes insipidus, alcohol
insensitivity to ADH -nephrogenic diabetes insipidus
psychogenic polydipsia
ANP release (atrial naturitic peptide) -cardiac arrhythmias, heart failure
osmotic diuresis (hyperglycaemia, hypercalcuria)
CKD -inability of diseased tubular cells to appropriately move sodium and hence concentrate urine
what causes coke coloured pee?
nephritic syndrome (glomerular haematuria)
what causes tea coloured pee?
myoglobinuria, usually secondary to rhabdo.
what causes frothy pee?
heavy proteinuria
what are the safest opioid painkillers to give in renal impairment?
fentanyl
methadone
buprenorphine
what is CVVH?
Continuous Veno-Venous Hemofiltration -continuous way of filtering blood like haemodialysis-one lasts for 72 hours.
