Renal

Question 1

What are the 5 functions of the kidneys?
(Describe) why it happens

Answer 1

1. Remove waste product filters to make urine from waste products.
   - Reabdorbs fluids - Secretes toxins -Millions of nephrons (Creatine breakdown on muscles and Urea waste products.
2. Controls acids/base/ Fluids/ Electrolyte
   -Glomerus where the acids/fluids and electrolytes leave the blood.
   - PCT sodium gets reabsorbed
   - DCT minimal reabsorbtion is where homes like ADH H2p reabsorbtion
   Aldosterone causes Na reabsorbtion (water follows)
3. Control of BP cell sensors at the DCT and glomerulus pick up on low BP
   By secretion of renin– Angiotesnion 1— ACE enzyme— Angiotensin 2
   Angio 2 causes: Vasoconstriction increases BP and Activates the reabsorbtion of Aldosterone Na (reputake= water follows)
4. Makes erythropoietin in kidneys, allowing for the bone to stimulate RBC production
5. Activates the vitamin D, stimulates the Ca lvl

Question 2

What is AKI?

Answer 2

When suddenly the kidneys stop working.
Pre-renal: (focus on blood) Decreased BP, Hypovolemia, hypotension and septic shock
Intra renal: Direct kidney damage such as Glomerulonephritis, and tubular necrosis.
Post renal: Obstruction of urine, such as kidney stones, tumours, and inflammation.

Question 3

what are the impacts of AKI (pre-,intra, post) and assessments?

Answer 3

Pre-renal: decrease in blood supply
Intra: unable to filter out wastes
post: back-up of urine in the ureters

Overall assessments: GFR, Urea 3.3.7.7mmol/L increase may show complications of filtering, Creatine 40-90mmol/L Produced by the breakdown of muscles (byproduct)

Question 4

What is the treatment for AKI?

Answer 4

Pre-renal- give fluids to restore blood flow
Intra- Fluids to flush out the antigens, give diuretics to limit sodium reabsorbtion, CT scan to assess (be cautious of dye allergy) and diuretics with gentamycin.
Post- Surgery / Catherisation

Overall treatment: Prevention and identifying the underlying cause
- ACE inhibitor (blocks the ace enzyme converting to angiotensin 2 acts as a vasodilator and prevents reptake of Na. - Control diet - EPO (stimulate the RBC) -Antibiotics - Kidney transplant/ dialysis

Question 5

What is CKD?

Answer 5

is a progressive disease where the kidney function deteriorates, caused by diabetes, hypertension (ischemia) or AKI (unresolved leads to glomerulonephritis)

Question 6

what does large-scale damage to the nephrons cause?

Answer 6

Decreased: GFR, Reabsorbtion, Filtration, secretions (renin decreased Na) and BP regulation systems.

Question 7

What are the s+s of CKD?

Answer 7

Azotemia (urea) SOB, Fatigue, weight gain fluid build-up, anemia due to (VD not being activated for RBC), decreased urine output.

Question 8

what are the stages of CKD?

Answer 8

The normal function is 100ml/min
Stage 3- 60ml/min
4- 30ml/min
5- 15ml/min (renal failure)

Question 9

what are the CKD treatments?

Answer 9

Teach and encourage a diet that is low sodium/potassium/phosphate
Fluid restriction
Don’t use OTC meds rough on the kidneys (NSAID)
Monitor and treat low RBC/ electrolyte imbalances (supplements, EPO, fluids)
Iron supplements (anemia)
Weight monitoring

Question 10

What is dialysis

Answer 10

Dialysis is a medical treatment that helps the body clear waste and excesss fluids when the kidneys are not working well.

Question 11

What are the two types of dialysis?

Answer 11

1. Haemodialysis uses a machone to filter blood then returned to you. Done commonly at hospitals. Serveral times a week.
   Monitory fluids
2. Peritoneal Dialysis (cavitty abdomen) as a filter. Fluids get drained and replaced. Can be done at home.
   Can be done in cycles.