Renal Flashcards
involuntary urination in children >4yo
enuresis
high BUN & creatinine
azotemia
swelling of one or both kidneys
hydronephrosis
GFR requiring adjustment of med dosages
GFR requiring dialysis
60
10-15
URINARY TRACT OBSTRUCTION
explanation
etiology
s/s
dx test
- Blockage that inhibits flow of urine through normal pathway
- Etiology - urolithiasis; BPH; tumor
- s/s - fever; n/v; flank pain; difficulty starting stream; limited urine; hydronephrosis
- Blunt percussion to the kidney causing pain indicates hydronephrosis
RENAL CALCULI
explanation
etiology & types
r/f
s/s
complication
- Urolithiasis - usually made of calcium or uric acid (also struvite, crystalline) - form inside kidney & can travel through UT
- Etiology - varies on type
- Struvite - infection
- Uric acid - gout
- r/f - dietary; infection; ↑ uric acid; genetics
- s/s - hydronephrosis; unilateral flank pain; n/v; retching with waves of pain; dysuria; hematuria; frequency with small voids; hesitancy
- More painful & complicated if stone gets stuck in ureter
CYSTITIS
etiology
r/f
s/s
- “UTI” or “bladder infection”
- Etiology - usually E. coli
- r/f - aging (loss of estrogen, skin changes around vulva); young girls; female; Foley; incontinence; sexual activity
- s/s - dysuria; frequency; hematuria; cloudy urine; malodorous urine; confusion in older pts
PYELONEPHRITIS
etiology
r/f
s/s
- “Kidney infection”
- Etiology - often ascends from bladder; usually E. coli
- r/f - frequent UTI; reflux; catheter use; enlarged prostate; CKD; kidney stones; DM; immunocompromise
- s/s - systemic - fever; n/v; malaise; colicky flank pain, waves of nausea; chills; dysuria (burning with urination); malodorous urine; hematuria; urgency; frequency; pyuria
STRESS INCONTINENCE
explanation
etiology
r/f
s/s
- Physical activity puts pressure on bladder
- Etiology - sphincter & pelvic muscles are stretched out and weak
- r/f - pregnancy; childbirth; obesity
- s/s - loss of urine with standing up, laughing, coughing, sneezing, lifting, sex, exercise
OVERFLOW INCONTINENCE
explanation
etiology
r/f
s/s
- Overfull bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle; medications
- r/f - enlarged prostate; kidney stones; neurological damage; tumors; DM; MS; trauma
- s/s - leaking urine without sensation of fullness__, with full bladder
URINARY RETENTION
explanation
etiology
r/f
s/s
- Inability to completely empty bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle
- r/f - recent surgery, especially to bladder; neurological damage; blockage; structural
- s/s - inability to empty bladder despite fullness
NEPHROTIC SYNDROME
explanation
etiology
r/f
s/s
- Too much protein excretion
- Etiology - damage to basement membrane - ↑ permeability of capillary wall
- r/f - infection; CKD; DM; lupus; medications
- s/s - proteinuria; edema; foamy urine; wt gain, ascites, puffy face (fluid leaving vascular compartment); fatigue; loss of appetite; hypoalbuminemia; HLD (liver’s response to hypoalbuminemia); ↓ antithrombin 3 (hypercoagulative state)
GLOMERULONEPHRITIS - NEPHRITIC SYNDROME
explanation
etiology
r/f
s/s
- Inflammation of glomerulus; Damage to basement membrane - larger molecules (RBCs, WBCs) able to enter filtrate
- Etiology - autoimmune, type 3 hypersensitivity - complexes get stuck in glomerulus & cause damage
- r/f - infection; immune disease; vasculitis; DM; HTN
- s/s - severe hematuria (cola colored)__; pyuria__; proteinuria; edema; HTN; oliguria
3 types of acute kidney injury
- Prerenal - blood flow to kidney
- Intrarenal - within kidney
- Postrenal - ureters, bladder, urethra
PRERENAL AKI
etiology
r/f
s/s
- Sudden renal hypoperfusion
- r/f - hemorrhage/blood loss__; HF; sepsis; severe dehydration; severe burns; pancreatitis; hepatitis; blood loss in surgery, injury
- s/s - hypovolemia; thirst; ↓ urine; dizziness; ortho hypotension; v/d; hemorrhage
INTRARENAL AKI
etiology
r/f
s/s
- Sudden episode of kidney failure due to direct glomerular damage
- r/f - infection; chronic disease (GN, nephrotic syndrome); toxins; medications
- s/s - vary - fever; rash; hematuria; oliguria; fatigue; dyspnea; nausea
POSTRENAL AKI
etiology
- Sudden episode of kidney failure - blockage below kidneys causes waste to back up
- Etiology - varies - tumor; enlarged prostate; stone
9th leading cause of death in US
CKD
gradual, progressive loss of kidney function
chronic kidney disease/renal failure
stages of renal failure with % kidney function
- 1 - 90% or more function
- 2 - 60-89%
- 3 - 30-59%
- 4 - 15-29%
- 5 - <15% - end stage renal failure
etiology of CKD
increasing amount of glomerular damage, leading to kidneys’ inability to manage filtration
- Acute bil kidney diseases
- Severe, prolonged circulatory shock/HF
- Nephrotoxins
- Mechanical obstruction
r/f for CKD
DM; HTN; CV disease; older age; Native American; African American; smoking; obesity; abnormal kidney; family hx
urinary sx of CKD
↓ urine output
azotemia
neuro sx of CKD
anxiety
depression
fatigue
h/a
sleep disturbance
encephalopathy
peripheral neuropathy
CV sx of CKD
HTN
HF
CAD
pericarditis
PAD
anemia (↓ erythropoietin)
bleeding
ocular sx of CKD
hypertensive retinopathy
GI sx of CKD
anorexia
n/v
bleeding
gastritis
respiratory sx of CKD
pulmonary edema
uremic pleuritis
pneumonia
endo/reproductive sx of CKD
hyperparathyroidism
thyroid abnormalities
amenorrhea
ED
integ sx of CKD
pruritus (azotemia)
ecchymosis
dry, scaly skin
metabolic sx of CKD
carbohydrate intolerance
HLD
MS sx of CKD
calcifications
osteomalacia
HEMODIALYSIS
function
accessed how?
performed when?
- Filters wastes and water from blood
- Helps control BP, balance K, Na, Ca
- Vascular access - ONLY use for dialysis
- Arteriovenous (AV) fistula
- AV graft
- Catheter
- 3x/week for 4 hours
PERITONEAL DIALYSIS
uses what?
how to use?
accessed how?
- Uses peritoneum to filter blood
- Must empty used solution & refill with fresh solution 4-6x/day
- Surgical catheter placement
BLADDER CANCER
prevalence
r/f
s/s
prognosis
- Very common cancer
- r/f - smoking; older age; male; exposure to toxins; parasitic infections
- s/s - hematuria; dysuria; back pain; pelvic pain; frequency
- Prognosis - >77% survive 5 years
