Kidneys Flashcards
normal range- 1.010- 1.025
Urine Specific Gravity
Regulation of blood pressure
Renin
recent malignancy •active or chronic infection •cardiac failure •chronic respiratory failure •extensive vascular disease •active autoimmune disease •morbid obesity
Contraindications to Kidney transplant
- Diuretics
- ETOH
- Diabetes insipidus
- Glycosuria
- Excess fluid intake
- Renal disease
Colorless to pale urine
- Pyuria
- Infection
- Vaginal cream
Yellow to milky white urine
o Hemoglobin breakdown o RBC, gross blood, menses o Bladder or prostate surgery o Beets, blackberries o Medication: phenytoin, rifampin, phenothiazine, cascara, senna,
Pink to red urine
o Dyes, methylene blue
o Medication: amitriptyline, triamterene, phenylsalicylatie
Blue, blue green urine
o Concentrated urine due to dehydration o Fever o Bile o Excess billirubin o Carotene medication
Orange to amber urine
o Old RBC o Urobilinogen o Bilirubinin o Melanin o Extremely concentrated urine o Medication: cascare, iron preparation, quinine
Brown to black urine
Normal – 0.7 – 1.4 mg/dl
Creatinine
10-20 mg/dl
BUN
280-300 mOsm/kg
Serum osmolality
gold standard test o X – ray of kidney bladder and ureter o Excellent tool to ID stones o Stones are radio opaque = glow in the dark o Stones will be seen clearly in X-ray
KUB
o Done through a cystoscopy
o Up the bladder and through the ureter
o the dye is shot up into the kidney
o it is a safer test b/c we don’t depend on the kidney to clear out the dye. The dye
Retrograde Pyelography
: obstruction to the upper part of the ureter
o Something has allowed the urine to back up and drown the kidney
Hydronephrosis
- Will make Ph of urine more acidic (urea, sulfuric acid, phosphoric acid)
- Good diet for patients with calcium stones
- Also good for stones related to UTI (struvites)
- Foods which metabolize in the body as acid
- The kidneys will secrete them in the urine as acid
Acid ash diets
• Meat • Eggs • Fish • Chicken • Cheese – high in phosphorus • Whole grain & legumes • Fruits ▪ Prunes ▪ Cranberry ▪ Plums ▪ Corn
Acid ash diet
▪ Avoid any acid in the body
▪ Avoid meat, cheese
▪ Stick with things that are high in calcium
▪ Calcium in an ingredient to all antacid
▪ Calcium binds with hydrochloric acid to alkaline the GI content
▪ Give pt. food high in calcium
o Milk
o Cream
o Buttermilk
o All fruits except acid list
o Green leafy vegetables
Alkaline Ash
- Is an alkaline stone
- Most likely produced in a urinary alkaline system
- The goal is to acidify the system so stones cant form
- Avoid oxalate foods:
Calcium oxalate stones
o Spinach o Rhubarb o Beets o Peanuts o Chocolate o Tea o Wheat bran o Strawberries
Oxalate foods
o For us to know: pt. should be on acid ash diet with limited protein
o Latest research suggests it is salt combined with protein which creats the environment for calcium phosphate stones to form
• Causes:
o Excessive calcium
o Excessive salt
o Immobilization
o High protein
Calcium phosphate
• UTI stones • Seen in patients with chronic systitis • Proteus is believed to be the organism that causes stone making environment particularly combined with antibiotic that come out in urine in crystallized form • Treatment: Acid ash diet / same as UTI o Lots of cranberry juice
Struvite stones
▪ Organ meat ▪ Fermented beverages ▪ Shrimp ▪ Gravy ▪ Lobster ▪ Salmon ▪ Cauliflower ▪ Mushrooms
Low purine diet/uric stones
• Metabolic defect • Pt cant metabolize amino acid/cystine • Runs in families • Pt will experience stones throughout their life time • Treatment: o Low protein diet o Alkaline ash o Penicillamine to reduce instances of stones
Cystine stone
Fever
Chills
Flank pain
Dysuria
Acute pyelonephritis
Fatigue Headache Weight loss Anorexia Polyuria Excessive thirst
Chronic pyelonephritis
