Renal Flashcards
Where do the kidneys sit
retroperitoneal between T12 and L3 (Right slightly more caudal to accommodate the liver).
primary functional unit of the kidney
nephron
Kidneys receive how much CO?
receive 20-25% of the cardiac output (1-1.25L)
Primary Functions of The Kidney
Maintenance of Extracellular volume and Composition (helps to concentrate and dilute)
Blood Pressure Regulation (Intermediate and Long term)
Excretion of toxins and metabolites
Maintenance of Acid-Base balance along w/ the lungs
Hormone Production
Blood glucose hemostasis
Hormones kidneys produce
erythropoietin (EPO),
calcitrol,
prostaglandins
What does low blood calcitrol cause
increases parathyroid hormone release, which increases the serum calcitriol level (active vit D) level. As serum calcium level rises it feeds back to reduce the serum level of PTH, which reduces the serum level of calictriol (negative feedback loop).
medications related to hormones that long term dialysis patients are on
iron and synthetic epo because dialysis negates the RBC’s
What is azotemia?
abnormally high levels ofnitrogen-containing compounds (such asurea,creatinine, various body waste compounds, and other nitrogen-rich compounds) in theblood. It is largely related to insufficient or dysfunctional filtering ofbloodby thekidneys.
What amount of body wt in non obese adult is total body water
60%
ICF vs ECF relationship
ECF is ½ the volume of ICF; kidneys effect ECF.
Two main components of ECF
plasma and interstitial fluid(IF)
Osmolality sensors in ant. hypothalmus
cause what?
Stimulate thirst
Vasopressin release; stop diuresis
sodium normal and cut-offs
normal 135 -145
cut-offs;
low; 125
high; 155
What percent of hospitalized patients have hyponatremia
15% …due to us giving IVF.
Causes of hyponatremia
Prolonged sweating- volume loss
Vomiting/diarrhea- GI disturbances
Insufficient aldosterone secretion- water overdose
Excessive intake of water; psych patients
Populations that we are concerned about hyponatremia with?
neuro and kids
forget about volumes-> too much fluid in kids neuro- regulate swelling/ brain edema, limit na or water
Causes of AMS
BG, Drugs, electrolytes, stroke
s/s for 130-135 meq/L na
asytmomatic
ha
n/v
fatigue
confusion
muscle cramps
depression reflexes
s/s 120-130meq/L na
malaise
unsteadiness
ha
n/v
fatigue
confusion
muscle cramps
s/s na <120meq/L
ha
restlessness
lethargy
sz
brain-stem herniation
respiraory arrest
death
most severe consequences of hyponatremia
sz, coma, death
Hypertonic saline dose
1meq/L/hr
Hyponatremia tx
Underlying cause
Normal saline- resuscitative
Hypertonic saline
Lasix- concentrate fluid ( get rid of free water)
Mannitol
130-135 = gatorade
max correction rate for hypona
6 mEq/L in 24 hours