Renal Flashcards
What are the 5 functions of the kidneys?
(Describe) why it happens
- 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. - 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) - 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) - Makes erythropoietin in kidneys, allowing for the bone to stimulate RBC production
- Activates the vitamin D, stimulates the Ca lvl
What is AKI?
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.
what are the impacts of AKI (pre-,intra, post) and assessments?
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)
What is the treatment for AKI?
Pre-renal- give fluids to restore blood flow
Intra- Fluids to flush out the antigens, give diuretics to limit sodium reabsorption, CT scan to assess (be cautious of dye allergy) and diuretics with gentamycin.
Post- Surgery / Cauterization
Overall treatment: Prevention and identifying the underlying cause
- ACE inhibitor (blocks the ace enzyme converting to angiotensin 2 (Constricts and retains Na) so ACE inhibiting Angiotensin 2 it acts as a vasodilator and prevents reuptake of Na. -
Control diet -
EPO (stimulate the RBC) -
Antibiotics -
Kidney transplant/ dialysis
What is CKD?
is a progressive disease where the kidney function deteriorates, caused by diabetes, hypertension (ischemia) or AKI (unresolved leads to glomerulonephritis)
what does large-scale damage to the nephrons cause?
Decreased: GFR, Reabsorbtion, Filtration, secretions (renin decreased Na) and BP regulation systems.
What are the s+s of CKD?
Azotemia (urea) SOB, Fatigue, weight gain fluid build-up, anemia due to (VD not being activated for RBC), decreased urine output.
what are the stages 5 of CKD?
The normal function is 1) 100ml/min
2- 68-89
3- a45-59 b30-44
4- 15-29
5- 0-15 (renal failure)
what are the CKD treatments?
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
What is dialysis
Dialysis is a medical treatment that helps the body clear waste and excesss fluids when the kidneys are not working well.
What are the two types of dialysis?
- Hemodialysis uses a machine e to filter blood then returned to you. Most common (done at hospitals) 3x a month and takes 3-5 hrs. Fistula vein+ artery infusion
Graft Synthetic material between artery and vein. - Peritoneal Dialysis (cavity abdomen) as a filter. Fluids get drained and replaced. Uses gravity to filter out from the peritoneal.
What is pyelonephritis
S+S
Upper UTI Infection of both or one of the kidneys
S+S: Flank pain, Chills and fever, pyuria (WBC in urine)>, leukocytosis (high WBC in blood), chills + fever, painful urination
what are the Lower UTI
S+S
Cystitis- Infection of the bladder
Urethritis- infection of the ureters
S+S: incontinence, hematuria, Increase in frequency and urgency
ELDERLY: Confusion, lethargic, new incontinence
Management of UTI
Antibiotics
Hydration flush out the bad tings
Analgesics can cause orange urine
What is acute glomerulonephritis?
S+S
Management
Acute inflammatory reaction in the glomerular capillaries
Antibodies get lodged into the glomeruli scaring and decreased GFR.
S+S: Hematuria, Azotemia (Creatine, Urea, BUN kidney disfunction.
Oedema, Malaise (Discomfort), Headache, proteinuria, Decreases GFR, increases BP, increase Urine specific gravity (increase in water retention)
MANAGEMENT: Diet— Restrictions on fluid, Na, Protein Increase carbohydrates (stop the breakdown of protein).
MONITOR— intake output, weight, abx, diuretics, antihypertensive.
