Measurement of Renal Function Flashcards
According to the British National Formulary (BNF) what are the 3 reasons why we need to measure renal function?
1 - identify renal impairment in your patient
2 - modification of dosages of drugs which are cleared by the kidneys
3 - plan appropriate management of renal dysfunction
When assessing a patient with suspected renal impairment, why would be measure fluid balance and what symptoms may be associated with fluid balance?
- oedema may be present
- can cause breathlessness
When assessing a patient with suspected renal impairment, what could an imbalance in the patients electrolytes cause, specifically in the heart?
- abnormal ECG:
- absent P waves
- broad QRS complex
- peaked T waves
When assessing a patient with suspected renal impairment, if we detect low erythropoietin levels which is produced by the kidney, what can this cause patients to present with?
- pallor
- fatigue
When assessing a patient with suspected renal impairment, if we detect low vitamine D3 (active vitamine D) levels which is produced by the kidney, what can this cause patients to present with?
- osteomalacia (softening of bones)
- bone pain
When assessing a patient with suspected renal impairment, what are some haemodynamic measurements that would provide information about the patients condition?
- pulse
- BP
When assessing a patient with suspected renal impairment, why are fluid charts useful that would provide information about the patients condition?
- determines if patient is dehydrated
- urine passed helps with this as well
When assessing a patient with suspected renal impairment, why would serial blood tests be useful?
- creatinine is filtered out in urine normally
- if this is high in urine then GFR is not functioning effectively
- FBC
When assessing a patient with suspected renal impairment, why would an arterial blood gas be useful?
- measures acid base shift
- pH
- metabolic acidosis
When assessing a patient with suspected renal impairment, why would urinalysis be useful?
- identify if glucose and proteins are present in the urine
What are the main imaging modalities used to investigate renal impairment?
- renal ultrasound scan (mostly first scan)
- CT/MRI Kidney Ureter Bladder
- Nuclear Medicine
What is the main manifestation of renal impairment?
- oedema
- can be felt on patients
- patients weight monitored (if in hospital)
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If blood is found in the urine, what does this indicate?
- blood loss is occuring in either the kidney, ureter or bladder
What is the most common cause of kidney disease?
- diabetes
In addition to doing a FBC, what other measures would you look at in the blood if you suspect the patient has impaired kidney function?
- serum creatinine
- serum urea
- serum HCO3-
- serum K+