Renal Flashcards
How is the urine flow obstructed? What are the anatomical and functional factors?
Anatomical = Can occur at any point along the urinary tract, including the kidneys, ureters, bladder, prostate, or urethra via blockage or compression
Functional = Can occur when the nerves or muscles that control urine flow are not working properly. Eg: decreased muscle action.
What does urinary obstruction result in?
It results in the back up and accumulation of urine in the tract buildup of pressure in urinary system.
The pressure can cause urine to flow backwards from the bladder and back into the kidneys.
As a result of this backup, there may be dysfunction or damage to the nephrons and glomeruli in the kidneys.
What are the S+S of urinary obstruction?
D P
Decreased urine flow AND output
Pain during urination AND Back pain
What is the solution for the urinary obstruction?
Depends on the causative factor such as surgery for taking out the kidney stone.
Most common cause for urinary obstruction?
Kidney stones = can be passed or if severe, surgery is needed.
What is AKI? What does it result in?
Acute kidney injury = Significant decline in renal function resulting in a decrease in fluid, electrolyte and ph balance.
What are the 3 renal category of causes?
1 = Pre renal
2 = Intra renal
3 = Post renal
Describe pre renal, the causes and the results.
PRE RENAL IS THE DECREASED BLOOD FLOW TO KIDNEYS CAUSED BY HYPOVOLEMIA OR RENAL ARTERY CLAMPING. RESULTS IN AKI
Describe Intra renal and the causes
Intra renal is due to the complications within the kidney such as tubular necrosis (most common), CKD or glomerulonephritis.
Describe post renal and the cause
Complications within renal tract that affect kidney function. The cause could be urinary tract obstruction.
What is AKI associated with also?
A decreased GFR (25% or more), Oliguria, Azotemia
S+S of AKI?
EDM
DIC
EDEMA, DECREASED URINE OUTPUT, METABOLIC ACIDOSIS
DROWSY, IRRITABILITY, CONFUSION
NAUSEA/VOMIT
Treatment for AKI?
Depends on causative factors BUT can be for example fluid management via IVF.
How do you manage AKI?
Management is specific to the cause but it also includes fluid, electrolyte and ph maintenance (maybe via dialysis). Maybe nutritional maintenance.
What does AKI increase the risk of?
CKD
What is the 2 major intrinsic cause of AKI?
glomerulonephritis and acute tubular necrosis
What is glomerulonephritis?
Its the leading cause of AKI and CKD. It’s basically the inflammation of the glomerulus resulting in GFR decreasing and glomerular permeability increasing.
S+S of glomerulonephritis?
Proteinuria = protein in urine = protein is too fucking big to be in our urine hence why it shouldn’t be.
Hematuria = RBC in urine = AGAIN to fucking big to be present in urine.
HAP HOE
HEMATURIA,AZOTEMIA,PROTEINURIA, HYPERTENSION, OLIGURIA, EDEMA
ALSO = We filter shit that shouldn’t be filtered but we also don’t filter shit enough.
What is the acute and chronic cause of glomerulonephritis?
Acute = streptococcal infection
Chronic = due to other systemic complications like diabetes.
What is chronic kidney disease? CKD
Progressive/irreversible loss of nephrons.
What is the pathophysiology of CKD?
Decrease in GFR results in the decrease in reabsorption and secretion of WASTE impairing the kidneys ability to maintain homeostasis including BP and the production of EPO (erythropoietin). This results in glomerular hypertension, hyper-filtration and hypertrophy. This will then result in glomerulosclerosis (SCARRING), tubular inflammation and fibrosis = THIS ALL LEADS TO FURTHER NEPHRON LOSS.
Optional:
(The scarring and loss of nephrons exacerbate the decrease in GFR leading to a vicious cycle of worsening kidney function.)
What are the causes of CKD?
G DAHP!!!!
GLOMERULONEPHRITIS
DIABETES
AKI
HYPERTENSION
POLY CYSTIC KIDNEY
What is the solution for CKD?
Depends on how many nephrons we lost. Fluid and dietary control, EPO supplements, use of ACE inhibitors. If these don’t work = dialysis or renal transplant.
