Osmosis Flashcards
1
Q
How does hypertension leads to chronic kidney disease
A
- hypertension causes thickened renal artery
- narrower lumen
- so less blood and oxygen to glomeruli
- ischaemia
- macrophages and foam cells secrete growth factor
- transformative growth factor 1 (TGF) - beta 1 causes mesangial cells to regress to mesangioblasts
- mesangioblasts secrete more extracellular matrix
- matrix leads to scarring of glomeruli (glomerulosclerosis)
- makes it more difficult for kidney to filter the blood
- causes chronic kidney disease
2
Q
How does diabetes cause chronic kidney disease
A
- excess glucose stick to proteins in blood vessel wall
- by non enzymatic glycation (no enzyme needed)
- most commonly affects efferent arteriole
- causes it to get more stiff and narrow (hyaline ateriole sclerosis)
- make it difficult for blood to leave the glomeruli and increases pressure within it
- causes hyper filtration
- mesangial cells secrete more extracellular matrix increasing the size of the glomeruli and causing glomerulosclerosis
3
Q
Give some causes of chronic kidney disease
A
- systemic diseases e.g lupus, rheumatoid arthritis
- infections e.g HIV
- long term use of medication e.g non steroidal anti-inflammatory disease
- toxins e.g tobacco
4
Q
Effects of chronic kidney disease on the body
A
- hypocalcemia (as less activation of vitamin D needed for calcium absorption)
- hyperkalemia (as less excretion of potassium)
- azotemia (build up of urea in the blood)
- renal osteodystrophy -brittle bones (as parathyroid hormone released (causes bones to release calcium) to compensate for hypocalcemia
- hypertension (as kidney releases renin to try and maintain blood pressure)
- anaemia (kidney does not produce erythropoietin that usually promotes production of red blood cells from bone marrow)
5
Q
What can large build up of urea in the blood lead to
A
- encephalopathy (affects nervous system)
- presents as asterixis (tremor of the hand when someone extends their wrist)
- pericarditis (inflammation of the lining of the heart)
- increased risk of bleeding as less clot formation (more urea in the blood means platelets are less likely to stick to each other)
- uremic frost (urea deposits in the skin)
6
Q
What is azotemia
A
- build up of urea is venous blood
7
Q
Symptoms of azotemia
A
- nausea
- loss of apetite
8
Q
Treatment of chronic kidney disease
A
- managing the underlying cause
- dialysis
- kidney transplant
9
Q
Give a cause of hyperkalemia
A
- chronic kidney disease
10
Q
What can a large build up potassium in the blood lead to
A
-cardiac arrhythmia
11
Q
What is a healthy GFR
A
Healthy glomerular filtration rate is 100-120ml/min/1.73m2
12
Q
Difference between chronic kidney disease and acute chronic injury
A
Damage to kidney causing decrease in glomerular filtration over time
Chronic kidney disease = greater than 3 months
Acute kidney injury = less than 3 months
