Renal Flashcards
What are the causes of chronic kidney disease?
Many…
Common, diabetes mellitus, hypertension, glomerulornephritis, polycystic kidney disease
What is the management of chronic kidney disease
Depends on stage
Dietary control:
Protein restriction
Vit d
Fluid evaluation
Sodium, potassium and phosphate restrictions
Erythropoietin supplements
ACE I hibitors or betablockers
Hyperglycemia control or insulin
End stage dialysis or transplant
What are the signs and symptoms of chronic kidney disease?
Uremia characterized by azotemia… leading to:
Fatigue
Anorexia
Nausea/vomiting
Weight loss
Hypertension
Pruritis
Neuro, skeletal muscle and CV changes
Describe the pathophysiology of chronic kidney disease
Progressive and irreversible destruction of nephrons…leading to
Decreased GFR
Decreased nephron function
Progresses in stages related to decline in GFR
Nephrons may still function and pick up extra workload
Excretion levels of water and salutes may be normal
Extra workload leads to:
Glom. Hypertension, hyperfiltration, hypertrophy
Glom. Sclerosis
Tubulinterstitial inflam. And fibrosis
Describe the pathophysiology of Urinary Tract Obstrucion
Could be anatomical or functional
Ie:
Kidney/renal stones
Compression (eg tumour)
Stricture or stenosis (narrowing) of Tract
Vesicouretal reflux (from bladder back
Into ureter)
Prostaric hypertrophy (compressing the urethra)
What does Urinary Tract obstruction cause?
It causes dilation proximal.to the blockage and accumulation of urine
Hydroureter (in the ureter)
Hydronephrosis ( in renal pelvis)
This effects:
1. Distal nephron
2. Proximal nephron
3. Glomeruli
Leading to….
Decreased GFR
Decreased reabsorption amd urine concentration
Decreased secretion
Increased risk of infection
Increased risk of AKI leading to CKD
Kidney stones
What are the signs and symptoms of urinary tract obstruction
Pain in abdomen below ribs
Nausea, fever and/or vomiting
Oliguria
What are the signs and symptoms of urinary tract obstruction
Pain in abdomen below ribs
Nausea, fever and/or vomiting
Oliguria
What is the pathophysiology of Acute Kidney injury (AKI)?
Sudden decline in renal function resulting in:
Reduced ability for the kidney to regulate fluid… electrolyte and acid-base
Categorized into:
Prerenal, intrarenal and post renal
Effects include
Reduced GFR
Increase in blood urea nitrogen
Increases serum creatinine
Oliguria
What are the causes for prerenal AKI?
Hint impairments in renal blood flow
Hypovolemia
Hemorrhage
Hypotension
Cardiac dysfunctional
Septic.shock
Renal artery stenosis or clamping
What are the causes of intrarenal (intrinsic) AKI?
Abnormalities or complications in the kidney itself ie:
Acute tubular necrosis
Interstitial nephritis
Glomerulonephronisis
Vascular disease
Tumors
Polycystic kidney disease
What are the causes for post renal AKI?
Complications within the renal tract ie:
Urinary tract obstruction
Ureteral destruction
Neutrogena bladder due to lesions/neuro disorders
More on AKI signs and symptoms
Decreases GFR by 35% or more
Oliguria reduction in urine output <0.5 ML/Kg over 6 hours or <400 mL per day
Azotemia or increased jn level of urea in the blood
Fluid retention and oedema
Metabolic acidosis
Andria (URINE OUTPUT <100 ML PER DAY?
Nausea/vomiting, a orexia
Neuro signs eg irritability, confusion and/or drowsiness
More on AKI signs and symptoms
Decreases GFR by 35% or more
Oliguria reduction in urine output <0.5 ML/Kg over 6 hours or <400 mL per day
Azotemia or increased jn level of urea in the blood
Fluid retention and oedema
Metabolic acidosis
Andria (URINE OUTPUT <100 ML PER DAY?
Nausea/vomiting, a orexia
Neuro signs eg irritability, confusion and/or drowsiness
