Kidney disease Flashcards
causes of renal failure
gentamycin - IV antibiotic
x-ray contrast
sepsis
diabetes
high bp
aki
signs of renal failure
low urea, pH, potassium levels
pulmonary and peripheral edema because of low water excretion
chronic kidney disease: low haemoglobin
managing renal failure
diuretics if no urinary failure
catheter in patients to monitor urine output, exclude obstruction of bladder to urethra
dialysis to remove fluid and K
IV to increase bicarbonate levels to reduce acidosis
kidney transplant for compliant patients
diagnose crepitations
sign of water in lungs / infection
could be sepsis
orthopnoea
shortness of breath when lying flat
neuropathy
disease of peripheral nerves causing numbness
poor sensation in hands/feet
JVP
jugular venous pressure
if raised, problem w right heart
fluid overload
needs diuresis
nephrotic syndrome
Nephrotic syndrome is a group of symptoms that indicate your kidneys are not working properly.
Amyloid in the kidney can cause leakage of protein in the urine resulting in a low blood protein level and swelling of legs or face.
These symptoms include. too much protein in your urine, called proteinuria.
low levels of a protein called albumin in your blood, called hypoalbuminemia.
edema.
bence jones protein
paraproteins in urine
sign of multiple myeloma
treating nephrotic syndrome
ace inhibitors to lower bp and proteins released in urine
diuretics
statins to reduce cholesterol
anticoagulants
fill catheter bag w whats needed (albumin…)
diagnosing nephrotic syndrome
dipstick for protein
check albumin
pulmonary renal syndrome
life threatening
usually caused by autoimmune disorder
small vessel vascularitis resulting in inflammation of kidney
Wegener’s
Granulomatosis with polyangiitis (Wegener’s), also known as GPA, is a rare blood vessel disease. It can cause symptoms in the sinuses, lungs, and kidneys as well as other organs. It is a potentially serious disease.
anca associated vascularitis
ANCA associated vasculitis (AAV) is an umbrella term for a group of multi-system autoimmune small vessel vasculitides that can present at any age
AAV diseases include microscopic polyangiitis, granulomatosis with polyangiitis (GPA, previously “Wegener’s granulomatosis”),
vascularitis- inflammation of vessels
haemoptysis
coughing up blood
main cause infection leading to mucosal inflammation and edema
rupture of blood vessels
symptoms of pulmonary renal syndrome
Cough
Dyspnea (laboured breathing)
Fever
Hematuria (blood in urine)
Hemoptysis
Peripheral edema
stiffness typical for vascularitis
diagnosing pulmonary renal syndrome
Serologic testing (blood serum)
Sometimes lung and kidney biopsies
hemoptysis not obviously attributable to other causes
Initial testing includes urinalysis for evidence of hematuria and red cell casts (suggesting glomerulonephritis), serum creatinine for renal function assessment, and CBC for evidence of anemia. Chest x-ray is done if not yet obtained.
Serum antibody testing may help distinguish some causes, eg. ANCA
Definitive diagnosis requires lung biopsy with findings of small-vessel vasculitis or renal biopsy with findings of glomerulonephritis with or without antibody deposition.
treating pulmonary renal syndrome
immunosuppressants and high dose steroids
corticosteroids
plasma exchange for pulmonary haemorrhage
cytotoxic chemotherapy
nephritic syndrome
Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.
inflammation of glomerulus
presents as hematuria, elevated blood pressure, decreased urine output, and edema
rhabdomyolysis induced renal failure
trauma
Rhabdo occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the kidneys and cause permanent disability or even death.
