Renal Flashcards
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Drug that works by inhibiting transporters in the loop of Henle
- this destroys the salt gradient, preventing water reabsorption
Loop diuretics (Lasix or Furosemide)
A general condition of elevated serum levels of nitrogen-containing substances in the blood including urea, creatinine, and uric acid
Azotemia
Doesn’t affect other boyd systems
not all causes are renal in nature
Drug that offects vasoconstrition in HTN by inhibiting the conversion of angiotensin I to angiotnesin II
ACE inhibitors
Results from overfilling the bladder with escape of urine
Overflow incontinence
The involuntary loss of urine with activies like coughing that increase intra-abdominal pressure
Stress incontinence
Struvite (magnesium ammonium phosphate) stones are associated with _____
Urea-splitting urinary tract infections
drug that blocks the NaCL symporter to block Na reabsorption, leaving water to remain in the lumen for excretion
Thiazide
- Assessment of renal function
- assesses how much blood is filtered in unit time
- dependent on cardiac output and renal blood flow
GFR (Glomerular filtration rate)
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Renal ischemia that is caused by
- acute tubular necrosis (ATN)
- glomerulonephritis
- pyelonephritis
- rhabdomyolysis
Intra-renal Disease
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Renal ischemia that is caused by
- heart failure
- shock
- any other condition that decreased renal perfusion
Pre-renal disease
- Byproduct of muscle metabolism
- reflects GFR and functional capacity of kidneys
Creatinine
Urgency and frequency associated with hyperactivity of the detrusor muscle
Urge incontinence
Central Diabetes Insipidus is associated with
_____
_____
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A problem with the posterior pituitary
- decreased ADH production
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Caused by damage to the hypothalamus or pituitary
- hypothalamus produces ADH which is then released by the poteriour pituitary
- Released from cells of the cardiac atria in response to increased streatch and work to conter fluid conserving effects to reduce blood volume and relieve blood pressure
- works generally opposite of aldosterone
ANP (Atrial natriuretic peptide)
- Associated with problem of the ADH receptors in the nephrons
- usually has normal ADH production
Nephrogenic Diabetes Insipidus
Polycystic kidney disease is a cystic genetic disorder of the kidneys
Adult form is _____ inheritance
Child form is _____ inheritance and _____ mortality
Adult form is dominant inheritance
Child form is recessive inheritance
_____ are the most common cause of upper urinary tract obstructions
Renal Calculi
Cysteine stones are associated with _____
Rare cysteine metabolism disorder
Calcium(oxalate or phosphate) stones are associated with ____
Excess calcium and parathyroid dysfunction
Uric acid (urate) stones are associated with _____
Gout
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Renal ischemia caused by
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obstruction of urine outflow from the kidneys
- ureter (calculi and strictures)
- bladder (tumors or neurogenic bladder)
- urethra (prostatic hyperplasia)
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obstruction of urine outflow from the kidneys
Post-renal disease
- Released from the posterior pituitary
- acts on the renal tubules to allow for water reabsorption that depends upon the formation of a sat garadient by the loop of henle
ADH
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Characterized by
- hematuria, azotemia (presence of nitrogen substance in the blood), proteinuria, edema, and hypertension
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May occur as a primary disorder such as acute poststreptococcal glomerulonephritis
- or secondary to lupus
Nephritic Syndrome
The renin-angiotensin system results in release of two important factors
Angiotensin II- potent vasoconstrictor
Aldosterone from the adrenal cortex- facilitates in sodium reabsorption
- Characterized by massive loss of proteinuria and lipiduria
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leads to hypoalbunemia and edema
- shift in colloid osmotic pressure
- fluid accumulation may be in tissues
- pleural effusions and pulmonary edema
- can cause hyperlipidemia due to the liver synthesizing lipids as it tries to compensate for albumin loss
Nephrotic syndrome
- Byproduct of protein metabolism
- measures amount of urea in blood
BUN (Blood urea nitrogen)
Refers to the clinical syndrome of renal failure with azotemia
Includes azotemia as well as acidosis, hyperkalemia, hypertension, anemia, and hypocalcemia
_____ may be indicated as treatment
Uremia
Dialysis may be indicated for treatment
Widespread dysfunction in other body systems including altered CNS function, neuropathy, ulceration of GI tract, N/V/HTN, skin discoloration, electrolyte imbalances, poor blood clotting, immunosuppression, pericarditis
- Drug that inhibits aldosterone
- blocks Na reabsorption
- increases K retention
Potassium sparing diuretics (spironolactone)
Causes of Nephrogenic Diabetes Insipidus
- Drugs such as lithium
- hypercalcemia
- Polycystic kidney disease
All 3 alter the ability of ADH to work
Secondary effects of polycystic kidney disease include cysts to _____
- Liver and pancreas
- Rarely the heart and brain
Central Diabetes Insipidus may be controlled by ____
Giving a modified form of vasopressin such as desmopression or DDAVP