Introduction to Renal Disease Flashcards

1
Q

What is the equation for GFR?

A

GFR = (UCr x UVol)/PCr

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2
Q

What are the problems with the GFR equation?

A
  • Can only be used reliably in patients with stable renal function
  • May be less accurate in certain populations
    • High/normal/near normal renal function
    • Children
    • Certain ethnic groups
    • Pregnant women
    • Unusual muscle mass, body habitus, or weight
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3
Q

What is the use of fractional Na excretion in the assessment of renal disease?

A

It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water reabsorption. Therefore the urinary and plasma concentrations of sodium must be compared to get an accurate picture of renal clearance.

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4
Q

Why is fractional urea excretion better to use than fractional Na excretion?

A

FE of urea is useful no matter what the range of values is while FE of Na is not helpful between 1-2%

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5
Q

What is normal urine output?

A

1500 mL/24 hours

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6
Q

Azotemia

A

Elevation in nitrogen containing compounds in the plasma and usually indicates renal problems

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7
Q

Uremia

A

Clinical syndrome that can accompany kidney failure, usually when advanced and/or severe due to an elevated level of urea.

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8
Q

Oliguria

A

Little urine output 500mL/day

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9
Q

Polyuria

A

High urine output 3000mL/day

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10
Q

Anuria

A

No urine output

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11
Q

AKI

A

Acute Kidney Injury

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12
Q

CKD

A

Chronic Kidney Disease

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13
Q

ESRD

A

End Stage Renal Disease

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14
Q

How is AKI defined?

A

An abrupt (within 48 hours) reduction in kidney function, defined as:
• ↑ in serum creatinine of > 0.3mg/dL OR
• Percentage ↑ in serum creatinine of 50% OR
• Oliguria of 6 hours

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15
Q

How is CKD defined?

A
  • Progressive decline in GFR over time
  • Duration at least three months
  • With or without albuminuria
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16
Q

Proteinuria

A

Protein in urine

• “Nephrosis”: > 3 – 3.5gm/24 hours

17
Q

Hematuria

A

Blood in the urine

Can be gross or microscopic (≥ 2 RBC/hpf)

18
Q

Nephrolithiasis

A

Kidney stones - most common are Ca2+ stones

19
Q

What are the characteristics of nephrotic syndrome?

A
  • > 3 – 3.5gm protein/24 hours
  • Hypoalbuminemia
  • Peripheral edema
  • Hyperlipidemia
  • Thrombophilia
  • Bland urinary sediment
  • Noninflammatory renal biopsy
20
Q

What are the characteristics of nephritic syndrome?

A
  • Inflammatory renal biopsy
  • Active urinary sediment
  • Hematuria
  • Dysmorphic RBC’s
  • RBC casts
  • Variable proteinuria
  • Azotemia, oliguria
  • Mild/moderate HTN
  • Other systemic features
21
Q

What is the ratio of ICW to ECW of the body fluid?

A

ICW is 2/3

ECW is 1/3

22
Q

What are crystalloid solutions?

A

They disperse across the ECW - examples are saline and lactated Ringer’s solution

23
Q

What are colloid solutions?

A

They remain within the plasma volume - examples are packed RBCs and albumin

24
Q

What is the function of Erythropoietin?

A

It regulates HGB/HCT concentration