LEC 4: Chronic Kidney Disease (CKD) Flashcards
What is the function of the kidneys?
- Filter waste products from the bloodstream
- Maintain fluid, electrolytes, and acid-base balance in the body
- Excrete metabolic waste products
What is the secondary function of the kidneys?
- Regulate blood pressure
- Facilitate bone density by calcitriol that helps create vitamin D
- Regulates bone density
- Stimulates bone marrow to produce RBC by erythropoietin
Glomerular Filtration Rate (eGFR)
- The volume of blood filtered by the glomeruli in one minute
- Deviations indicate impaired renal function
- Normally about 125 mL/min per glomeruli
- Can be estimated based by serum creatinine measurement
*Abnormal levels means kidneys are not functioning
What is chronic kidney disease (CKD)?
- Progressive, irreversible, loss of kidney function
- Loss of nephrons
- GFR is less than 60 mL/min for 3 months or longer
- Damages ranges from stages 1 to 5
- Early stages usually undetectable
- Stage 5 is the end stage for renal disease
When will you start to see GFR symptoms?
Will not have GFR symptoms until stage 4
*More than 75% of the nephrons have to be damaged for symptoms to occur
What percentage of nephrons need to be damaged for symptoms to occur?
More than 75% of the nephrons have to be damaged for symptoms to occur
What are the clinical manifestations of Uremia?
- Psychological changes
- Cardiovascular system
- Gastrointestinal system
- Reproductive system
- Metabolic disturbances
- Hematological system
- Neurological system
- Respiratory system
- Integumentary system
- Urinary system
- Electrolytes disturbances
- Musculoskeletal system
*Substances are being retained and every body system is affected
Uremia
An excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be normally excreted in the urine. Is the terminal clinical manifestation of kidney failure.
How does uremia occur?
Results from build up of waster products and excess fluid associated with kidney failure
- Start to see in stage 4 and 5 of GFR
Uremia: Psychological Changes
- Anxiety
- Depression
Uremia: Cardiovascular System
- Hypertension
- Heart failure
- Coronary artery disease
- Pericarditis
- Peripheral artery disease
Uremia: Gastrointestinal System
- Anorexia
- Nausea
- Vomiting
- Gastrointestinal bleeding
- Gastritis
Uremia: Endocrine/ Reproductive System
- Hyperparathyroidism
- Thyroid abnormalities
- Amenorrhea
- Erectile dysfunction
Uremia: Metabolic Disturbances
- Carbohydrate intolerence
- Hyperlipidemia
Uremia: Hematological System
- Anemia
- Bleeding
- Infection
