Nephrology Flashcards
Acute Glomerulonephritis
what: inflammation of the glomerulus
why: immunogenic (recent strep infection or impetigo), ischemia (hypotension/shock), toxic
s/s: oliguria, hematuria, proteinuria, edema, fluid overload, hypernatremia
dx: ASO titer, BUN/Cr, urinalysis
treat: supportive treatment, fluid restriction, anti-htn/diuretics, sodium restriction
4 causes of kidney injury
Renal vascular disease (vasculitis, thrombosis, hemolytic uremic syndrome)
Glomerulonephritis (post-strep A, SLE)
Acute tubular necrosis (toxic, ischemia, sepsis)
Interstitial disease (acute interstitial nephritis, malignancy)
Causes of AKI
prerenal
intrarenal
postrenalP
Prerenal AKI
s/t decreased perfusion
dehydration, hypovolemia, shock
Intrarenal AKI
ATN, glomerulonephritis
Postrenal AKI
obstruction
BPH, stones
1st stage AKI
slight increase in BUN/Cr
voiding normally
2nd stage AKI
oliguria/anuric phase
progressive increase in BUN/Cr/serum creatinine
metabolic acidosis
hypervolemia
hyperkalemia/hyperphosphatemia
S/S of hyperuremia
anorexia
N/V
pruritus
3rd stage AKI
return of renal function. glomeruli filter blood but tubules still impaired –> lack of concentration –> ++ diuresis
can void 4-5 L/day
hypovolemia, F/E imbalances
Oliguria
<500 mL in 24 hours
Anuria
<100 mL in 24 hours
Causes of kidney stones
too much uric acid
salt in urine crystallizes
high calcium
struvite stones (infection)
Kidney stones rf
immobility
infection
high calcium, vitamin d, PTH
family hx
dehydration
urinary stasis
Lithotripsy
procedure used to break up large kidney stones
soundwaves projected to kidney to break up stone
pt needs to be NPO
