Renal 2 Paulson Flashcards
Chronic Kidney Disease (CKD) is defined by kidney damage or a decrease in kidney function for greater than or equal to ____ months
3
What are the two most common causes of CKD?
Diabetes & HTN
THis is a product of muscle metabolism, excreted by the kidneys
Creatinine
Plasma filtration by the glomerulous
Glomerular Filtration Rate
_________ _______ is the gold standard for GFR measurement but never used. ______ is used instead
inulin clearance, MDRD & Cockcroft-Gault
When calculating GFR in obese or fluid overloaded patients, we need to remember to use _____
ideal body weight
Refers to all types or proteins that might be in the urine
Proteinuria
What is the GS to check for proteinuria?
24 hr urine (urine:Cr ratio)
T/F: exercise can cause proteinuria?
True (less concerning cause of proteinuria)
Specific to CKD and pathomneumonic for kidney damage?
albuminuria
This detects early CKD?
albuminuria
Preferred screening for albuminuria?
Urine albumin : Cr ratio (yearly)
Normal albumin level
<30
Microalbuminuria
30-300
Macroalbuminura
> 300
Early detection or mod to severe albuminuria in diabetics can be treated with
ACEI or ARB
What is the target A1C for diabetics with CKD
7.0%
When calculating CKD, we use what two things to measure?
GFR and albumin
G1
> 90
G2
60-90
G3a
45-60
G3b
30-45
G4
15-30
G5
<15
What size is a normal kidney on U/S?
10 cm
*shrunken kidney indicated CKD and can help differentiate between acute and chronic kidney issues
People with CKD4 and above should be on a __________
Phosphate binder (sevelamer)
CKD + hyperparathyroidism tx?
Vit D
What foods should someone with CKD and hyperphosphatemia avoid?
Dark soda, protein, dairy
Treatment for CKD and hyperkalemia?
Low potassium diet (Kayexelate)
At what GFR does a patient start dialysis?
10-15
This type of dialysis uses a AVF and is done 3x/wk
hemodialysis
Sample probably contaminated
squamous epithelial cells
Renal tubular cells/casts
ATN/AIN
RBC casts
Glomerulonephritis
WBC casts
interstitial nephritis, pyelo, inflammation
Fatty casts
nephritic syndrome
hyaline casts
can be normal
muddy brown casts
ATN
This is damage to the filtering of the glomerulous so protein gets out in urine, not as much serum albumin so liver tries to help = get extra lipids produced
Nephrotic syndrome
This disease is characterized by:
- Edema
- Proteinuria (foamy urine)
- Low serum albumin
- Hyperlipidemia
Nephrotic syndrome
_________ is the name given to a collection of different signs and symptoms that occur as a result of inflammation in the kidneys. This inflammation causes the kidneys to work less effectively. It also causes protein and red blood cells to leak from the bloodstream into the urine.
Nephritic syndrome
This disease is characterized by:
- Hypertension
- Hematuria
- Proteinuria (less than nephrotic syndrome)
Nephritic syndrome
