Renal Flashcards
Stimulated by hypoxia, kidneys will initiate
erythropoiesis by secretion of the hormone erythropoietin
Pre-renal AKI is caused by
inadequate perfusion of kidneys
Retroperitoneal fibrosis, renal stone disease, bladder carcinoma, prostatic enlargement, cervical carcinoma can all cause what type of AK
Post renal injury
Erythropioetin is usually required when eGFR
less than 15
Hydropnephrosis from ultrasound would indicate what?
Post renal AKI
Reference range for creatinine (male)
64-104
Nephrotic syndrome?
massive proteinuria, hypoalbumin, oedema, lipidurea
Nephritic syndrome is a presentation of glomerular disease and is characterised by
haematuria proteinuria hypertension AKI throat infection swollen ankles
Management of CKD
BP and cholesterol control fluid balance anaemia bone metabolism acidaemia dietary advice medication review
Rapidly progressive glomerulonephritis is a presentation of glomerular disease and is characterised by
acute nephritis
AKI
Joint pains, rash, fevers, red eyes
Metabolic acidosis what anion gap?
High or normal
loop diuretics inhibit uptake of ?
Sodium, potassium, chloride, water
Side effect of thiazide?
Hypovolaemia
Post renal AKI is caused by what?
obstruction to the renal tract (anywhere from renal pelvis to urethra)
What part of the nephron is the site of reabsorption for Na+ with H2O and Cl- in exchange for K+ and is controlled by aldosterone?
Cortical collecting duct
Benefits, complications and contraindications of peritoneal dialysis
Benefits - can be done at home
Complications - peritonitis, sclerosing peritonitis
Contraindications - presence of a hernia, severe arthritis, previous surgery with adhesions
Counter current mechanism allows what?
Salt and water conservation
4 drugs that can accumulate if the kidney has been damaged
Antibiotics
Digoxin
Opiates
Lithium
Recognition and treatment of hyperkalaemia
Peaked T wave on ECG
treat with calcium gluconate, glucose + insulin, withdraw any drugs causing hyperkalaemia, renal replacement therapy
kidneys filter how much of cardiac output?
25% 2m glomeruli
Proximal convulated tubee/ recovers how much filtrat
70%
How are the kidneys part of the RAAS
secrete renin from the juxtaglomerular apparatus, which converts angiotensinogen to angiotensin I
as a result, patients with kidney disease often develop high b.p
Nephron consists of?
glomerulus
renal tubule
interstitium
enveloping vascular network
Decreased activation of vitamin D due to kidney disease is a cause of
Decreased calcium level and subsequently stimulates secretion of parathyroid hormone (secondary hyperparathyroidism), releasing calcium from the bone, i.e. renal osteodystrophy
Contraindication for dialysis?
Severe cardiac failure
Tc99 is sued for what?
Exact glomerular filtration rate
How is calcium reabsorbed?
the proximal tubule and thick ascending limb reabsorb more than 90% of the filtered Ca2+ by passive processes that is coupled to Na+ reabsorption.
Together, the distal tubule and collecting duct reabsorb 8% of the filtered Ca2+ by an active process.
Phosphate reabsorbed ?
proximal tubule
Amino acids in urine = disease where?
Proximal tubule
% of diabetics getting diabetic nephropathy?
20-30%
Loop diuretics can cause what?
Hypokalaemia
Medullary collecting duct?
Site of urine concentration
Regeneration of bicarb dependent on what enzyme?
Carbonic anhydrase (acetazolamide)
Where do loop diuretics work?
Ascending limb
Spironalactone acts where?
Cortical collecting duct
Where do thiazides work?
Distal tubules
Amiloride works where?
Cortical collecting
