Kidney Function Flashcards
Acute Kidney Injury
rapid reduction in renal function resulting in a failure to maintain fluid, electrolytes, and acid base hemostasis
Changes in labs during AKI
increase in BUN, increase in creatinine, decreased GFR, increased azotemia
Changes in I&Os in AKI
oliguria (decreased urine output)
Medical diagnoses that increase risk of AKI
pre-existing CKD, renal problems, heart disease, diabetes, HTN
Medication use that increase risk of AKI
NSAID, ace inhibitor, diuretics, contrast dyes
Why does old age increase risk of AKI
loss of nephrons
Medical situations that increase risk of AKI
post surgical, trauma, hypotensive episodes, septic shock (major cause)
Prerenal AKI
inadequate blood flow to the kidneys
Causes of prerenal AKI
decreased CO, blood shunted from kidneys, low volume due to blood/fluid loss, decreased perfusion from sepsis/meds, occlusion to kidneys
Causes of intrarenal AKI
acute tublar necrosis!!!, nephrotoxic agents
Post renal AKI
obstruction in the urinary tract
Post renal AKI causes
stones, tumor, BPH, clots
What is the absolute minimum urine output
30mL/hr
Oliguria measurement
<20mL/hr, <500mL/day
Anuria measurement
<100mL/day
Common electrolyte imbalance with AKI
hyperkalemia
What type of acid base imbalance is common with AKI
metabolic acidosis due to renal tubules not being able to excrete hydrogen ions and reabsorb bicarbonate
Purpose of renal replacement therapy
ultrafiltration, removal of excess fluid, removal of waste
What is the most aggressive and quick type of hemodialysis
intermittent hemodialysis
Common venous sites for dialysis
internal jugular, femoral veins
What common venous site poses the greatest risk for stenosis/thrombosis
subclavian vein
Diet while on dialysis
increase carbs, limit protein and fluids
Complications of dialysis
hypokalemia, dehydration
Arteriovenous fistula
graft between artery and vein for long term/permanent dialysis access
Considerations for fistulas
no bp or blood draws on arm with fistula, avoid tight clothing, thrill and bruit assessments daily, CMS assessments
Peritoneal dialysis
dialysis is introduced through tenckhoff cath, done at home, risk of periotnitis, used for chronic kidney disease
Chronic kidney failure
occurs when the kidney cannot remove waste or perform regulatory functions for at least 3 months
What is the best measure of kidney function
GFR
Clinical manifestations of CKD
anemia, metabolic acidosis, calcium/phosphorus imbalances but asymptomatic until later stages
Uremia
kidney function declines to the point that all body systems are affected because waste products are not taken care of properly
When is dialysis required
CKD
What affects respiratory function with CKD
hypoxia associated with anemia
