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Renal medicine > Introduction to renal medicine > Flashcards

Introduction to renal medicine Flashcards

1
Q

What are the broad functions of the kidney?

A

Homeostasis - maintanance of the internal environment of the body

Hormone secretion

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2
Q

How does the kidney regulate fluid and electrolyte balance?

A

Volume status - regulates fluid balance through production of urine

Electrolyte levels - Na, K, urea and creatinine

Osmolarity (concentration of particles exerting an osmotic pressure) - glucose

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3
Q

How does the kidney regulate acid-base balance?

A

Bicarb regeneration

Removal of fixed acid

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4
Q

What small molecules does the kidney recover?

A

Sugar - presence indicates diabetes

AAs - loss occurs in disease of the proximal tubule.

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5
Q

What substances are excreted by the kidney?

A

Nitrogenous waste (urea and creatinine)

Drugs - antibiotics, digoxin, opiates, lithium

Drugs can accumulate in kidney disease

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6
Q

What is the role of the kidneys in erythropoiesis?

A

Erythropoietin (produced by kidneys?). Stimulated by hypoxia. Patients with kidney disease develop anaemia.

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7
Q

How is the kidney involved in calcium and phosphate balance?

A
  • Secretes actived form of vitamin D - 1,25 dihydroxy cholecalciferol (ie kidneys active vit D)

First stage performed in the liver

Second stage performed in the kidneys -1,25 dihydroxycholecalciferol

Increases absorption of calcium from the gut

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8
Q

What is the relevance of calcium phosphate metabolism?

A

In kidney disease there’s decreased activation of Vit D. Decreased Ca level. Stimulates secretion of parathyroid hormone - secondary hyperparathyroidism, releases Ca from bone and develop bone disease (renal osteodystrophy)

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9
Q

How is the kidney involved in blood pressure control?

A

Renin secretion - converts angiotensin I - II

Patients with kidney disease often have high blood pressure

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10
Q

What pecentage of cardiac output do the kidneys recieve?

A

25%

Acutely ill patients - lower blood pressure, reduced blood supply to the kidneys and decreased urine output.

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11
Q

How can one measure kidney function?

A

U&Es

Bicarb (22-29 normal)

Chloride (95-108 normal)

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12
Q

What are U&Es?

A

Sodium 133-146

Potassium 3.5-5.3

Urea 2.5-7.5

Creatinine 64-104

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13
Q

What diagnostic info can be gained from urine tests?

A

pH, haematuria, proteinuria, glucose, nitrites and leucocytes

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14
Q

What is the value of an abdominal x ray?

A

May identify calcification.

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15
Q

What is the value of renal tract ultrasound?

A

Assess the size of the kidneys

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16
Q

What is the value of a CT KUB?

A

ID calcification - need iodinated contrast.

17
Q

What is the value of MRA?

A

Assesses blood supply

Renal medicine (9 decks)

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