Lecture 63 - Interpretation & Diagnosis Flashcards
local/intrinsic autoregulation responds to
chemoreceptors and baroreceptors
systemic/extrinsic autoregulation responds to
norepinephrine from SNS activation and RAAS
inadequate renal blood flow decreases what
- ability to filter solutes
- ability to adjust electrolyte concentrations
what would inadequate renal blood flow manifest as on a blood test
- increased serum BUN, creatinine, SDMA
- abnormal electrolytes
azotemia
increase in non-protein nitrogen compounds in blood
uremia
azotemia that is associated with clinical signs
prerenal azotemia
decreased renal blood flow/GFR
dhydration, hypovolemia, and hypotension
renal azotemia
decreased functional nephrons/renal insufficiency
postrenal azotemia
interference with urine exiting body
urolith, ruptured bladder
increased specific gravity indicates
- increased solutes
- decreased water volume
appropriate USG when the patient is euhydrated
water intake = losses
urine DOES NOT need to be concentrated/diluted
variable USG
appropriate USG when the patient is dehydrated
inadequate water intake
Urine is concentrated
USG >.12
appropriate USG when patient is overhydrated
excess water intake
urine is dilute
USG <.10
kidney [renal] failure
clinical condition with severely compromised kidney function either hemodynamic, filtration, and/or excretory in nature
what are 2 things used to diagnose kidney disease
- decreased GFR
- lack of ability to concentrate urine
clinical markers of GFR
- BUN
- serum/plasma creatinine
- SDMA
what other ways can you assess renal function
- UPC ratio
- fractional excretion of electrolytes
- gamma-glutamyl transferase : creatinine ratio
- urine sediment exam
increased UPC indicates
abnormal amount of protein present from glomerular dysfunction and tubular injury
gamma-glutamyl transferase : creatinine ratio
- proximal convoluted tubule lined by brush border
- enzyme released from brush border in PCT
- increased by renal tubular damage
fractional excretion of electrolytes
measure of electrolytes and creatinine in urine and plasma
increased indicates renal tubular injury
casts in urine
cellular debris can clog inside of tubule, build-up causes casts
Acute Kidney Injury
- oliguria/anuria
- acutely ill
- normal BCS
- decreased urine
- hyperkalemia
- +/- large painful kidney
Chronic Kidney disease symptoms
- PU/PD
- chronic
- decreased BCS
- polyuria
- hypokalemia
- small, nonpainful kidneys
- anemia
- hypercalcemia
phases of acute kidney injury
- injury/insult
- initiation
- extension
- maintenance
- +/- recovery
the grading of acute kidney injury is based on
creatinine concentration
describe CKD
- progressive loss over 3 months
- increased creatinine
- decreased ability to excrete waste products
how is CKD staged
blood creatinine or SDMA
