Renal Flashcards
What is the main function of the kidneys?
Entire blood supply circulates 12 times a day
-filter out waste products
How much urine does the bladder typically hold?
- What are the risks for a person that holds urine?
400-500 cc
Risk for infection if person holds urine.
What are the functions of the kidneys?
Water balance
Electrolyte regulation
Synthesis of Vit D
Regulation of RBC production
What further issues do patients with kidney problems have?
Difficulty storing calcium due to vitamin D synthesis issues.
What is:
- Osmolarity
- Osmolality
- Osmolarity= Ratio of solutes to water
- Osmolality= Dilution of urine
What are the functions of aldosterone?
- Reabsorbs sodium
- Causes secretion of potassium
What are the two types of natriuretic peptides?
Where are they secreted?
- ANP
- Secreted by heart cells in atria with increase of pressure in atria
- BNP
- Secreted by heart cells in ventricles with increased ventricular pressure
What do natriuretic peptides do?
Inhibit sodium and water from being absorbed.
Where is vitamin D received?
What is its main purpose?
Obtained in diet/synthesized by sun exposure
Aids in absorption of calcium/potassium
What is erythropoietin?
When is it made?
Stimulates bone marrow to produce RBC
Made with tissue hypoxia
How can renal function be deteced in a blood test?
- High creatinine leves indicate kidney failure
- (normal= 0.6-1.2)
- High BUN (blood urea nitrogen)
- (normal= 10-20)
What items should not be in urine and indicate kidney function failure?
- Glucose
- Ketones
- Albumin/protein
What main test detects creatinine in blood and urine?
What does it indicate?
Glomelular filtration rate= indicates specific kidney filtration function
What considerations should be made for aging adults?
- Nephrons die (kidney function slows/declines)
What are urinary tract obstructions?
Block that interferes with urine flow in any site of urinary tract.
What are Kidney stones (calculi)?
What are the risk factors?
Formation of mineral buildup in kidneys
Risks
- ]Fluid and diet (high calcium, high sodium)
- Men
- Low fluid intake
What are the main types of kidney stones?
What causes them?
Calcium oxalate or calcium phosphate (most common)
- Immobilization
- Hyperparathyroidism (Calcitonin increase)
What are struvite stones made of?
What are the main characteristics of these stones?
Magnesium/ammonium
- Usually very large
What are the main treatments for kidney stones?
- Lithrotripsy (soundwaves breakup stones)
- Increase fluid intake
- Decrease mineral containing foods
What is a neurogenic bladder?
What usually causes it?
Bladder issues caused by a neurologic problem.
- associated with spinal cord injury/lesions in sacral spinal cord.
What is overactive bladder syndrome (OBS)?
What are the symptoms?
Involuntary bladder contraction during bladder filling that results in incomplete urine emptying/urine retention.
- Frequency, urgency, nocturia
What are postvoid urine evaluations?
After voiding, scan bladder to look for retaining of urine.
What is a common sign of renal adenoma (cancer) and bladder cancer?
Painless hematuria (blood in urine)
What are urinary tract infections (UTI)?
What is the most common cause?
Inflammation of urinary epithelium caused by bacteria?
Usually caused by E coli
What is acute cystitis?
What are the common symptoms?
UTI of the bladder
- Frequency
- Dysuria (painful urination)
- Hematuria
What is interstitial cystitis?
What are the symptoms?
Inflamed bladder not due to bacteria
- Small urine volume
- Pelvic pain
- Frequency
What are the treatmens for interstitial cystitis?
No treament; symptom relief
Pyelonephritis
What is ti?
Infection of upper urinary tracts (ureters, renal pelvis)
Acute Pyelonephritis
What is it caused by?
What is a common symptom?
Ascending uropathic microorganisms along ureters,
- Pain in lower back (CVA tenderness)
Chronic Pyelonephritis
What physical alterations are made to kidneys?
- Scarring of kidneys
- Increased risk for for infections.
What is glomerulonephritis?
What are the symptoms?
Infection of glomerulus that causes:
- Acute kidney failure
- Oliguria (<30 mL/hr)
- High blood pressure
- Proteinuria (protein in urine)
What does nephrotic syndrome caused by glomerulonephritis?
- Huge amounts protein in urine
- Low protein in blood
- Small amounts of hematuria (microscopic)
What are the symptoms of nephritic syndrome caused by glomerulonephritis?
- High amounts of hematuria
- Lower amounts of proteinuria (still abnormal)
- Azotemia (waste products in blood)
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What are the most common causes of glomerulonephritis?
- Group A strep infections
- Impetigo
- Viral infections (sometimes)
What are these results of acute kidney injury:
- Renal insufficiency
- Renal failure
- End Stage renal failure
- Renal insufficiency= working but not fully
- Renal failure= Signifincant loss of renal function (dialysis)
- End Stage renal failure= Renal function <10%
What are the common signs of renal insufficiencies/renal failure?
- Uremia and azotemia (waste products in blood)
- Higher creatinine/BUN
What are these causes of acute renal failure:
- Prerenal
Most common cause of AKI
Severe drop in blood pressure
or
Drop in blood flow to kidneys
What is this cause of acute renal failure:
- Intrarenal
Direct damage to kidneys (infection, drugs)
What is this cause of acute renal failure:
- Postrenal
Obstruction of urine flow (prostate, stones)
What is chronic kidney disease?
What is acute kidney disease?
Chronic= Progressive loss of kidney function that affects all organs
Acute= sudden decline in kidney function (drugs, bloodloss)
What occurs with water and electrolyte balances with chronic kidney disease?
Water retention; edema
- Sodium and potassium secretion increases early.
- Once oliguria sets in, potassium retained
What is hemodialysis?
- how often is it performed?
Treatment that uses machine to filter blood when kidney function declines.
Received 3-4 hours a week
What are these types of hemodialysis:
- Arteriovenous fistula
- Arteriovenous graft
- Arteriovenous fistula= Surgically connection of artery and vein (longest life)
- Arteriovenous graft= Subcutaneous connection of artery and vein using other material.
What are the advantages of AV fistula vs AV graft for dialysis?
- AV fistula takes 2-3 months to heal before it can be used
- Fistula has a longer life line.
- Graft must be used for those with diabetes.
What is peritoneal dialysis?
Treatment of hypertension and heart failure using semipermeable peritoneal membrane for dialysis.
Takes much longer.
