Renal Flashcards
What are some systemic consequences that can result from kidney failure
- uremia
- hyperkalemia
- acidosis
- HTN
- volume overload/Pulmonary edema
- nitrogenous waste buildup in blood
What are 3 causes of acute kidey injury
- A sudden, serious drop in blood flow to the kidneys
- Direct damage from medications, toxins or infections
- A sudden blockage that stops urine from flowing out of the kidneys
What does acute kidney injury present like?
- onset can occur within hours
urine output frequently decreases (oliguria) or stops completely (anuria), resulting in
- generalized edema from water and sodium retention
- high concentrations of products of renal excretion such as nitrogen, uric acid and potassium
If acute kidney injury is not recognized early what can it lead to?
heart failure, hyper kalemia, metabolic acidosis
What are the 3 main types of vascular access in pts that require dialysis
- AV fistulas
- AV grafts - synthetic
- dialysis catheters
What is an AV fistula?
A graft that comes out of the skin directly connecting an artery and a vein. This allows for easy access when doing dialysis
What are some disadvantages of fistulas?
- they take 2-4 months to amture
- 30-40% of primary fistulas fail to mature adequately
- pts with vascular disease or frequent phlebotomy may have inadequate vessels
What are some complications from fistulas?
- fistula infection (staphyococccus)
- pseudo aneurysms
- nerve injury
- digital ischemia
What are some things that we as PCPs need to remember when treating pts with fisutlas
- do not take bp in arm with fistula
- no venipuncture or IV infusions in fistula arm
What is peritoneal dialysis?
Kidney dialysis that is done in the peritoneal cavity using the peritoneal membrane to filter toxins instead of through a machine
What are the 2 types of continuous peritoneal dialysis
- Continuous Ambulatory Peritoneal Dialysis
- Individuals exchange fluid on their own 4 times daily - Continuous cycling peritoneal dialysis
- uses a dialysis machine during the night to replace and clean fluids
What are some dialysis emergencies?
- vascular access problems
- hemorrhage
- hypotension
- chest pain
- severe hyperkalemia
- air embolism
What is Cystitis?
- inflammation of inner lining of bladder (type of UTI)
S and S of Cystitis
- frequent urination
- urgency to urinate
- burning
- fever
- chills
- lower abdo pain
Are UTIs more common in men or women?
Women, due to the shorter urethra
What are some causes of UTIs?
- hygiene
- sexual intercourse
- bathing suits
- urinary retention or obstruction
- foley catheters
- medications
What is renal cholic (Renal Calculi)
- pathologic stones that oringate in renal pelvis that shifts to the ureters
- results from supersaturation of the urine with insoluble salts
At which age does renal cholic occur in pts?
30-50
S and S of Renal Cholic
- Unilateral, severe, sharp flank pain and tenderness
- radiation to gorin
- waxing-and waning cyclical nature of pain
- frequent urination or urgency
- hematuria
- dysuria
- restlessness
- N and V
- diaphoresis
