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Renal Exam 1 > Quantification of Renal Function > Flashcards

Quantification of Renal Function Flashcards

1
Q

Endocrine function

A

Secret renin by the JG apparatus
Produce and secrete PG and kinins
Produce and secrete erythropoietin

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2
Q

Metabolic function

A

Activate Vit D3 (calcitriol)
Gluconeogensis
Metabolism of insulin, steroids and xenobiotics

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3
Q

Excretory Function

A

Maintain balance between input and output of water and solute from the body

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4
Q

Glomerular filtration

A

Passive diffusion of water and small ions into the Bowman’s capsule and proximal tubule
Protein bound compounds are too larger and enter the peritubular circulation

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5
Q

Define Secretion

A

Primarily through the proximal tubule via active transport

Anionic and cationic transporters

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6
Q

Anions

A

Probenicid

Penicillin

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7
Q

Cations

A

Creatinine
Cimetidine
Procainamide

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8
Q

Define Reabsorption

A

Water a solute occurs throughout the nephron

Drug occurs along the distal tubule and collecting tubules

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9
Q

Highly ionized compounds are

A

NOT reabsorbed unless pH changes within the urin

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10
Q

Intact Nephron Hypothesis

A

Renal disease is the net result of REDUCED NUMBER OF APPROPRIATELY FUNCTIONING NEPHRONS but remaining nephrons compensate

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11
Q

Single Nephron GFR

A

Increases in the remaining nephrons and the whole kidney GFR represents the sum of SNGFR of the the remaing functional nephrons

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12
Q

Kidney is NOT

A

one homogenous functioning organ; lots of working parts

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13
Q

Signs and Symtpoms of Renal Dysfunction

A 
HTN
Edema
Electrolyte imbalance
Anemia
Increase urine output
Metabolic acidosis
Bone demineralization
Hyperkalemia (muscle weakness)
Mental confusion
N/V
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14
Q

BUN

A

Amino acids are metabolized to ammonia then to urea

This process is dependent on protein availability and hepatic function

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15
Q

GF reabsorbs how much urea

A

50% of the filter load in the proximal tubule

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16
Q

How does urea pass?

A

Passive diffusion and dependent on reabsorption of water

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17
Q

Normal BUN

A

5-20 mg/dL

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18
Q

Normal BUN:creatinine ratio

A

10-15:1

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19
Q

> 20:1 =

A

Pre-renal injury (ischemia)

20
Q

Creatinine CANNOT

A

be reabsorbed if filtered

21
Q

Creatinine is a product of

A

Creatine metabolism from the muscles and is dependent of muscle mass

22
Q

Noraml Creatinine

A

0.5-1.5 mg/dL

23
Q

Creatinine elimination

A

GFR declines = Creatinine increases

24
Q

Jaffe Reaction

A

Reacts noncreatinine chromogens (not present in the urine) which may result in falsely increased serum creatinine concentrations

25
Q

CrCl =

A

Urine creation X Urine volume
divided by
serum creatinine X duration of urine collection

26
Q

Normal CrCl

A

Men: 90-139 mL/min
Female: 80-125 mL/min

27
Q

Physical Factors that may mess with CrCl

A 
Age, weight, gender
Diet
Diurnal variation
Drugs (cimetidine, trimethoprim, probenecid)
Exercise
28
Q

Serum Creatinine concentration is dependent on

A

Input function/formulation rate and output function/elimination rate

29
Q

Things that can alter serum creatinine

A 
Muscle mass
Exercise
Elderly patietns
Diurnal variation
Dietary intake of creatine
30
Q

Serum Creatinine can rise

A

50% within 2 hours of meat meal

31
Q

Cystatin C

A

Synthesized by all nucleated cells at a constant rate
May provide and ideal marker of GFR independent of age and gender
COSTLY

32
Q

Cystatin C + Corticosteroids for renal transplant

A

Dose dependent increases in cystatin C

33
Q

Abnormal urinalysis substances

A 
Blood
Protein
Glucose
Ketones
Urobilinogen
Bililrubin
WBC
34
Q

Urine pH

A

4.5-7.8

High pH = bacteria

35
Q

Urine Specific Gravity

A

1.003-1.030
Weight of an equal volume of urine : water
Dependent on water intake

36
Q

Urine Glucose

A

Normally absent
Can be see when serum glucose exceeds 160-200 mg/dL
DM detection

37
Q

Urine Ketones

A

Diabetic ketoacidosis = acetoacetate and acetone in the urine

38
Q

Urine Nitrates

A

UTI

39
Q

Urine Leukocyte Esterase

A

UTI

40
Q

Urine Heme

A

Hemolysis or Rhabdomyolysis

41
Q

Urine Protein or Albumin

A

30-150mg/day protein

30 mg/day albumin

42
Q

Albumin is NOT

A

filtered due to size and negative charge

43
Q

CrCl =

A

((140-Age)XIBW)/SCr *72

X 0.85 of female

44
Q

IBW

A

50 kg + 2.3 kg over 5 ft

45 kg + 2.3 kg over 5 ft

45
Q

GFR

A

175 X {SCr ^-1.154) X (age^-0.203) X 1.212 (black) X 0.742 (female)

Underestimates if GFR is > 50

Renal Exam 1 (8 decks)

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