Renal Flashcards
What is the Glomerular Filtration Rate (GFR)?
Speed at which blood moves through the glomerulus; 90-125 L/min=normal rate
What is the GFR an indicator of?
Kidney health
Where along the loop of Henle is NA+ reabsorbed?
Thick Ascending limb
Where is water primarily reabsorbed in the nephron?
mainly proximal tubule and descending limb of loop of Henle; final reabsorption occurs in collecting duct
Where is K+ primarily reabsorbed in the nephron?
Proximal tubule and thick ascending limb of the loop of Henle
What are the components of Raas?
Renin, Angiotensin, and Aldosterone
What is the action of Renin and what are the ways it gets released?
Gets released in 3 different ways
1- drop in BP in the afferent arteriole
2- drop in Na+ in the DCT
3- rise in SNS innervation at the kidney
Enzyme that converts Angioyensinogen to Angiotensin 1
What is the process of Angiotensin 1 conversion?
Angiotensinogen is protein stored by the liver; released and is met by Renin and converted to Angiotensin 1–>travels to lungs–> ACE converts it to Angiotensin 2
What is the purpose of Angiotensin 2?
1- generalized vasconstriction
2- constricts the efferent arteriole–>increased GFR–>increased Na+ in DCT
Where is Aldosterone stored and what is its purpose?
Adrenal Cortex
Stimulates reabsorption of Na+ in DCT and collecting ducts therefore increasing H20
Pathophysiology of pre-renal ARF
Decreased blood flow = decreased GFR resulting in oliguria
Risk Factors: blood loss, hypotension, dehydration
Pathophysiology of intrinsic ARF
cell damage leads to inflammation and impaired filtration
Risk factors: nephrotoxic drugs, infection, autoimmune disorders, glomerulonephritis
Pathophysiology of post renal ARF
tissue damage d/t back pressure and swelling from obstruction
Causes: kidney stones, tumors,BPH
Stage 1 of ARF
-lasts hrs to days
-subtle symptoms
-potentially reversible injury
Stage 2 of ARF
Oliguric stage
-decreased Urine output
-fluid overload
-electrolyte imbalances
Stage 3 of ARF
Diuretic stage
-gradual increase in urine
-risk of dehydration
-electrolyte loss as kidney recovers
-significant loss of NaCl
Stage 4 of ARF
Recovery stage
-gradual return to normal fxn with potentially reversible damage
Electrolyte imbalance of Stage 1 ARF
mild hyperkalemia
mild metabolic acidosis
Electrolyte imbalance of Stage 2 ARF
Hyperkalemia, Hyperphosphatemia, Hypocalcemia, Metabolic acidosis
Electrolyte imbalance of Stage 3 ARF
risk of hypokalemia
hyponatremia and hypovolemia
Electrolyte imbalance of Stage 4 ARF
Electrolytes stabilize
Normal range of BUN
6-20
Normal range of Creatinine
0.6-1.3 mg/dL
What are the most common causes of chronic kidney disease
DM, HTN
End stage CKD is classified by GFR of ?
<15
How does DM and HTN contribute to CKD
increased blood glucose/BP cause microvascular injury to the glomerulus; eventually leads to fibrosis of the tubules in the nephron
