Lab Evaluation of the Kidneys Flashcards

1
Q

What are the functions of the kidney? (5)

A

Excretion of nitrogenous waste
Regulate water and electrolyte concentration
Regulate acid base balance
Endocrine function e.g. produces active metabolites of vitamin D
Elimination of toxic substances

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2
Q

How does the kidney achieve its non endocrine functions and are these passive or active mechanisms?

A

Glomerular filtration- passive
Tubular reabsorption and tubular secretion- passive and active

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3
Q

In the proximal tubule, what happens to the solute concentration and the fluid volume?

A

Solute- no change, H+ comes in and joins NH3 as other solutes are removed
Fluid volume- decreases as water and solutes are removed

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4
Q

In the Loop of Henle, what happens to the solute concentration?

A

descending- solute conc increases as water is removed and urea is added
ascending- the solute is removed and water stays so decreases conc

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5
Q

What happens to the solute concentration and fluid volume in the collecting tubule?

A

both decrease as water leaves and is resorbed by the body (obvs ADH dependent)

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6
Q

Give an example of a condition that may cause solute diuresis?

A

Hypercalcaemia inhibits ADH causing too many solutes
Hyperglycaemia causes wash out that ‘washes’ solutes away

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7
Q

Apart from solute diuresis, what else can cause a loss of renal concentration?

A

Loss of medullary hypertonicity e.g. damaged medullary tissue, poor blood flow

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8
Q

What is Azotaemia?

A

increase in non protein nitrogenous compounds in the blood due to decreased glomerular filtration rate (this includes urea and creatinine)

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9
Q

What is Uraemia?

A

clinical signs reflecting renal failure- anorexia, vomiting, diarrhoea, GI haemorrhage

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10
Q

What affects the BUN/ levels of blood urea nitrogen in the blood?

A

Protein catabolism, diet, GI haemorrhage

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11
Q

What may increase the Creatinine level in the blood?

A

Muscle mass- e.g. greyhounds
Bladder Rupture- abdominal fluid creatinine will be much higher than the serum value.

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12
Q

What is Pre Renal Azotaemia and how does it affect GFR?

A

pre renal azotaemia is issues with internal circulation leading to decreased renal blood flow and therefore decreased GFR

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13
Q

What is Renal Azotaemia and how does it affect GFR?

A

Renal azotaemia is an acute kidney injury that causes loss of functioning nephrons and therefore decreased GFR

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14
Q

What is the main symptom of Post Renal Azotaemia and why?

A

leakage of urine due to issue in the ureters and bladder which causes vasoconstriction and pressure build up

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15
Q

What other system (apart from urinary) is likely to be affected in a patient with Pre Renal Azotaemia?

A

Cardio system- likely have a decreased cardiac output

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16
Q

How reliable are Urea and Creatinine as markers of Chronic Kidney Disease?

A

Not very- serum urea and creatinine only tend to rise at end stage kidney disease

17
Q

What does Renal Hyperparathyroidism occur secondary to?

A

Chronic Kidney Disease

18
Q

Why does Renal disease cause Secondary Renal Hyperparathyroidism?

A

Renal disease causes a decrease in an enzyme (alpha hydroxylase) needed to create Vitamin D- less Vitamin D means lower levels of free calcium, decreased calcium causes the body to release large/ increased amounts of Parathyroid hormone

19
Q

How does Chronic Kidney Disease effect Potassium levels in the body?

A

CKD causes polyuria as a symptom which ‘washes away’ the K+
Also causes concurrent acidosis- shifts potassium out to compensate

20
Q

Why are amylase and lipase levels elevated in renal disease?

A

because there’s decreased renal inactivation/ clearance of the enzymes

21
Q

Why does renal disease cause anaemia and what kind of anaemia does it cause?

A

Causes normocytic, normochromic anaemia due to decreased erythropoietin production