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Physiology 1 > Overview Of Renal Diseases > Flashcards

Overview Of Renal Diseases Flashcards

1
Q

What age does GFR start to decrease and how fast does it decrease?

A

Age 40, 1 ml per year

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2
Q

How can you measure kidney function?

A

Blood tests (creatinine or formula)
Urine output
Elimination of radioisotopes

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3
Q

Why is creatinine a good measure of GFR?

A

Produced in the body at steady rate

Small changes at good function-> large GFR changes

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4
Q

Why is urea not a great measure of GFR function?

A

Not reliable and levels may change for other reasons

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5
Q

What are the pre-renal causes of AKI?

A

Hypervolaemia (haemorrhage or volume depletion)
Hypotension (cardinogenic or septic shock)
Renal hypoperfusion/ vasoconstriction (NSAIDs, ACE)

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6
Q

What are the types of intrinsic renal disease?

A

glomerular, tubular, vascular, interstitial, obstruction

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7
Q

What are the two types of glomerular renal disease?

A

Glomerulonephritis or systemic disease

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8
Q

Give an example of a tubular renal disease

A

Acute tubular necrosis

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9
Q

Give an example of an interstitial renal disease

A

Interstitial nephritis

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10
Q

What proportion of AKIs are caused by a prostatic obstruction?

A

25%

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11
Q

How can an obstructive uropathy be corrected?

A

Catheter or nephrostomy

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12
Q

When is the ideal time to start renal replacement therapy?

A

Once AKI is established and unavoidable but before overt complications have developed

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13
Q

What are the benefits of starting RRI early?

A

Avoids metabolic abnormalities and problems of volume overload

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14
Q

What are the risks with starting RRI early?

A

Exposes patient to potential venous thrombosis, bacteremia or haemorrhage for anticoagulants and some will recover before the need for treatment

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15
Q

What are the indications for needing acute dialysis?

A

Hyperkalaemia, severe acidosis, fluid overload and symptomatic uremia

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16
Q

What does symptomatic uremia include?

A

Pericarditis and encephalopathy

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17
Q

How can glomerular disease present?

A

Asymptomatic urinary abnormalities, CKD, nephrotic or nephritic syndrome

18
Q

Where can a non-visible haematuria be found?

A

Anywhere in the renal tract

19
Q

What can a non-visible haematuria be caused by?

A

UTI/ bladder carcinoma/ glomerulonephritis

20
Q

What are the thresholds for nephrotic syndrome?

A

Albumin <30g/L
Proteinuria >3g/24hr
+/- oedema

21
Q

What is the difference between nephrotic and nephritic?

A

Nephritic is nephrotic with an abrupt onset

22
Q

What is the histology of nephrotic syndrome?

A

Severe inflammation and necrosis of the glomeruli and often glomerular crescent formation

23
Q

What are the most common causes of kidney disease in the UK?

A

Diabetes, hypertension, CUD, glomerular disease, genetic

24
Q

How many stages of CKD are there?

A

6- 1, 2, 3a, 3b, 4, 5

25
Q

What are some risk factors for kidney decline?

A

Diabetes, hypertension, CVD, smoking, ethnicity, AKI, obesity, NSAIDs, untreated urinary outflow obstruction, proteinuria

26
Q

What is the building block for most kidney treatments?

A

Blocking certain parts of the RAAS system

27
Q

What changes do you see in a diabetic nephron?

A

Increased feedback from macula densa -> afferent vasodilation -> inc NaCl and glucose filtration -> increased NaCl and glucose reabsorption via SGLT2

28
Q

What is the new class of drugs to improve onset of kidney failure?

A

SGLT2 inhibitors

29
Q

What are the complications of declining GFR and ESRF?

A

Haematological, bone, CVS, immunological, malnutrition

30
Q

What is used to correct renal anaemia?

A

Iron injections

31
Q

What is the maximum conservative lane of ESRF treatment?

A

Do all other stuff apart from replacement renal therapy

32
Q

When is dialysis inappropriate?

A

May have an unacceptable impact on quality of life, patient choice, imminent death, other issues

33
Q

What are the three options for renal replacement therapy?

A

Haemodialysis, transplant, peritoneal dialysis

34
Q

What are the two mechanisms of solute movement?

A

Diffusion or convection

35
Q

When does diffusion occur?

A

Difference in solute concentration either side of the membrane

36
Q

What is convection?

A

Movement of solute in association with water pressure

37
Q

What is the basic process of haemodialysis?

A

Blood passes down one side of a highly permeable membrane
Water and solutes pass across the membrane
Infuse replacement solution with physiologic concentrations of electrolytes

38
Q

How does peritoneal dialysis happen?

A

Pop a catheter into a persons abdomen and infuse dialysate fluid into it

39
Q

What is fluid movement determined by in peritoneal dialysis?

A

Osmosis

40
Q

Where can transplants come from?

A

Live or deceased donors

41
Q

Where are transplanted kidneys placed and plumbed into?

A

Into the iliac fossa

External iliac artery and vein

Physiology 1 (65 decks)

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