renal 1 Flashcards
how are renal diseases classified?
pre-renal, renal and post-renal
what are the two classifications of renal function?
- Acute :–Rapidly Progressive (within hours)–Process is reversible
- Chronic:–Irreversible loss of renal function; affects all organ system–Progressing to end-stage renal failure(over months or years)
define renal insufficiency
Decline in renal function to about 25% of normal or GFR of 25 to 30 ml/min
•Levels of serum creatinine and urea mildly elevated
define renal failure
- Significant loss of renal function
* When less than 10% remains End stage renal failure (ESRF)
define uremia
- Syndrome of renal failure
- Elevated blood urea & creatinine levelaccompanied by fatigue, anorexia, nausea,vomiting , pruritus & neurological changes
- Due to–Retention of toxic waste–Deficiency state / Electrolyte disorders
define Azotemia
- Increased serum levels; Frequently increased creatinine
* Renal insufficiency / failure cause azotemia
what do Azotemia and Uremia have in common
Accumulation of nitrogenous waste products in blood
what is acute kidney injury (AKI)?
Abrupt (within hours) reduction in renal function
AKI is associated with Oliguria, what is this?
passing small volume of urine - less than 30ml/hr or less than 400ml/day
how is the diagnosis of AKI confirmed?
confirmed when blood test reveal–High conc. of Urea(BUN- blood Urea Nitrogen)and Creatinine- not being excreted
what does biochemical testing of AKI reveal?
Metabolic acidosis due to inability to excrete hydrogen ion
–Hyperkalaemia due to impaired excretion of K+ ion
what does BUN stand for and what is it?
Blood Urea Nitrogen-Urea produced by breakdown of amino acids
what is the normal range of BUN?
2.5-6.6mmol/L (15-40 mg/ dL)
what happens if the GFR decreases to renal disease or blockage/ decreased blood flow to kidney?
BUN increases
what is Creatinine?
is an end product of muscle metabolism
Muscle mass is constant; creatinine is constant
what is the normal levels of creatine in the blood?
–Male : 64 -111μmol/L(0.72 –1.26 mg/ dL)
–Female: 50 -98 μmol/L (0.57-1.11 mg/dL)
is creatine reabsorbed?
Creatinine is neither reabsorbed norsecreted, just freely filtered
.•Amount Excreted = Amount Filtered
what does AKI result in?
Results in failure to maintain electrolyte and acid –base homeostasis
what’s a common etiology of PRE-RENAL AKI?
decrease in renal perfusion through a decrease in effective extracellular volume.
what is a common aetiology of intra-renal AKI?
Renal parenchymal injury
what is a common aetiology of post-renal AKI?
Urinary tract obstruction
what are the causes of pre-renal failure?
decrease in extracellular volume
Altered renal vascular regulation
what causes a decrease in extracellular volume?
hypovolaemia
decrease in cardiac output
Systemic dilatation
what causes altered renal vascular regulation?
Afferent arteriolar vasodilation (Prostaglandins)(preglomerular following cause inhibition
Efferent arteriolar constriction (Angiotensin II)(postglomerular following cause inhibition)
what are examples of intra-renal failure?
- Acute tubular necrosis
- Glomerulopathies
- Malignant Hypertension
- Coagulation defects
- Bilateral acute pyelonephritis
- Renal artery/vein occlusion
- Allograft rejection
- Drug allergy
- Infection
- Tumour growth
what are some causes of post-renal failure?
Results from obstruction of the urinary tract •Urinary stones •Prostatic hypertrophy •Blood clots •Neoplasms •Unusual for drugs
