Pre-renal kidney disease Flashcards

1
Q

What are the two types of pre-renal kidney disease?

A

Acute - over days or weeks

Chronic - over months or years

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2
Q

How can you measure acute pre-renal kidney disease?

A

Increase serum creatinine

Decrease in urine output

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3
Q

What are the 3 categories of kidney disease?

A

Pre-renal - damage occurs due to problems with perfusion of the kidneys

Intrinsic - damage to the kidney itself => glumerulonephritis

Post-renal - blockage to flow of urine out of the kidney

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4
Q

What percentage of CO goes to the kidney in health?

A

25%

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5
Q

Which 3 conditions lead to pre-renal injury?

A

Circulatory shock - entire CO decreases

Reduced circulatory volume - intravascular volume depletion

Reduction of blood flow only to the kidneys

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6
Q

What is circulatory shock?

A

Low BP

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7
Q

How does circulatory shock lead to pre-renal kidney injury?

A

Not enough blood volume or CO to perfuse the kidney

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8
Q

What are the causes of circulatory shock?

A

Cardiogenic shock

Hypovolemia - not enough circulating volume

Vasodilation - caused by sepsis or anaphylaxis

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9
Q

Why does reduced circulating volume lead to pre-renal kidey injury?

A

Kidneys are very affected by blood volume - even though the BP remains normal

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10
Q

What causes intravascular depletion?

A

Not enough fluid intake - physically dependant, no access to fluids

Loose a lot of fluids - urine , GI tract, oedema and skin

Redistribution of water to extravascular spaces

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11
Q

How does excess water leave the body through the skin?

A

Sweat, fever or burns

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12
Q

How does excess water leave the body through the GI tract?

A

Malabsorption, inflammation and cholera

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13
Q

How does excess water leaver the body through urine?

A

Diuretics

Osmotic diuresis - glycosuria

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14
Q

What are the clinical presentation of redistribution of water to extravascular spaces?

A

Oedema

Adequate total fluid but inadequate fluid volume in the circulation

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15
Q

What things cause a reduction of blood flow only to the kidneys?

A

Arterial narrowing - artery stenosis

Vasoconstriction - medication

Arterial thrombosis - trauma

Venous thrombosis - pro-coagulant state

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