Kidney (Renal) Disease Flashcards
normal GFR rate
100 to 130 mL per min
less than 100 ml/min is abnormal kidney dysfunction
inulin
gold standard in renal function tests (100% accurate about GFR rate)
plant starch IV infusion
Creatinine
byproduct of metabolism and compare blood and urine(renal clearance) levels
overestimates GFR
abnormal creatinine blood levels for kidney dysfunction
more than 1.3 mg/dL
abnormal creatinine urine levels for kidney dysfunction
less than 500 mg/day
BUN
blood urea nitrogen
byproduct of DNA and protein metabolism
abnormal BUN levels for kidney dysfunction
more than 18 mg/dL
azotemia
abnormal lab results with no clinical signs
uremia
azotemia + clinical symptoms of kidney dysfunction (renal failure) like HTN, anemia, edema, oliguria (less urine production)
Nephritic diseases
hematuria and mild/none proteinuria
glomerulonephritis
nephrotic diseases
no hematuria but significant proteinuria (foamy urine from albuminuria)
hyperlipidemia, edema, and HTN
resolve completely or ESRD / kidney failure
diabetic nephropathy
50% of all nephrotic diseases
leading cause of ESRD
leading cause of death in T1DM
endothelial glycation leading to thickened basement membrane and scars the kidney
RF: T1DM > T2DM, HTN, smoking + race (AA)
Tx: control BP, BG, lipids and smoking cessation or if ESRD (dialysis or transplant)
Minimal Change Disease
most common nephrotic syndrome in children (1 - 7 years old)
idiopathic (70-90%) + NSAIDS, vaccines, viral infection
Face edema is noticed as first sign and pathology under EM (loss of foot processes, appearance of microvilli, and vacuolation)
Tx: steroids! (95% total recovery)
Acute Tubular Necrosis
necrosis of tubular epithelial cells
most common cause of acute renal failure
recovery is possible with timely treatment
types of acute tubular necrosis
ischemic: 50% due to vascular collapse (shock or hypotension) or pre-renal vessel occlusion (HTN, DM, thrombosis)
Toxic due to contrast media in x-ray (25%) or antibiotics, NSAIDs, other substances
hypertensive nephropathy
sclerosis of renal arteries + glomeruli secondary to chronic HTN
2nd most common cause of ESRD
types of HTN nephropathy
benign nephrosclerosis (55%) and only 1-5% lead to ESRD
malignant nephrosclerosis (diastolic is more than 130) 45% and 33% lead to ESRD
renal failure / ESRD
less than 15 ml/min GFR OR dialysis or less than 10% renal function
primarily caused by DM, HTN, and GN (glomerulonephritis) ~ 78%
Tx: dialysis, transplant, acceptance of death from uremia
types of renal failure
Acute Renal Failure: less than 3 mos and caused by vascular collapse (shock)
- reversible effects
- acute oliguria, azotemia/uremia, fatigue, decreased appetite, N/V/HA
Tx: diuretics, transplant, dialysis
Chronic Renal Failure: more than 3 mos and irreversible damage
RF: DM, HTN, GN, CVD, Idiopathic
Oliguria, Azotemia/uremia, fatigue
Transplant indicated for ESRD (95% 1 year survival rate)
- rejection is main concern
ocular manifestations of renal disease
band keratopathy (calcium in cornea), posterior subcapsular cataract (prednisone), or renal retinopathy
renal cell carcinoma
80-90% of all renal cancers usually 50-70 year old
Hematuria, lose weight, dull flank pain, palpable mass
RF: smoking, family history of VHL, preexisting renal disorder
nephroblastoma / Wilm’s Tumor
most common kidney cancer in children
palpable mass, pain, HTN, hematuria, ANIRIDIA (25%)
95% unilateral but 90% of bilateral end up ESRD
RF: AA
90% 5 year survival rate
transitional cell carcinoma
98% of bladder cancer usually over 65 year old
RF: smoking!! + occupational exposures and chronic bladder infections
Hematuria, Dysuria, Polyuria
UTI
urethritis - cystitis (bladder) - ureteritis - pyelonephritis(kidney) - septic body
ascending order
caused by e coli (70-90%) + stasis urine flow
Fever, Dysuria, bacteriuria, pyuria (pus)
Nephrolithiasis
kidney stones caused by solute supersaturation, low urine volume, abnormal urine pH, infection
Hematuria + renal colic (super painful)
Calcium is most common type
Tx: hydration/pain meds or ultrasound or sx
