Renal: AKI and CKD Flashcards
renal autoregulation of GFR
incr in BP and its effect on aff and eff arteriole
-same with decr BP
INCR BP
- constricts afferent arteriole
- dilates efferent arteriole
DECR BR:
- dilates afferent
- constricts efferent
define renal insufficiency
decline of renal function to <60 ml/min
describe acute renal insuff
AKI= 50% increase in creatinine or incr in BUN or azotemia
-ABRUPT–within 48 hours–decr in kidney function–>retention of urea and other nitrogenous waste productions–>disregulation of ECF volume and electrolytes
AKI used instead of ARF bc theres a range of loss of renal function
describe chronic kid failure
- characterized by?
- major etiologies
- kid damage or decr in GFR for >3 MO
- characterized by any of the following
- ->albuminuria
- ->electrolute and acid base disturbs
- ->anemia
- ->urine casts
- ->image finfings
- ->abnm renal biopsy
two major causes=DM and HTN
define end stage renal failure
less than 10% of renal function remains
uremia
- causes
- cm
syndrome of renal failure
-elev urea and cr
CM=fatigue, anorexia, nausea, vom, pruritis, neuro changes
*causd by retention of toxic wastes, deficiency states, electryo imabalcne and proinflammatory states
Azotemia
- what is it
- causes
- leads to?
***NITROGEN IN THE BLOOD
vs uremia= urea in te blood
INCR: serum urea + creatinine
renal insuff or renal failure cause it
both this and uremia lead to accumulation of nitrogenous waste prod in blood
criteria to classify AKI
R-->risk I-->injury F-->failure L-->loss E-->end stage dz
**3 progressive levels of AKI
risk injury
failure–>with 2 outcomes determinants: loss and end stage renal dz
list three phases of AKI
- oliguria (maintenace phase)
- HyperK—met. acidosis
- diuretic phase (recovry)
Oliguria
- define
- how does it happen
<400 ml of UO/day
- HOW DOES IT HAPPEN
1. alterations in renal blood flow*** - efferent arteriolar vasoconstriction
- impaired autoregulation
- Tubular necrosis ***
* necrosis of the tubules causes sloughing of cells—cast formation–ischemic edema— results in obstruction - backlead
* GFR normal—but tubular reabs leaks filtrate–accelerated by permeability
in hospital type of tubular obstruction?
ATN
acute tub necrosis
rhabdo
TYPES of AKI
- pre-renal (reversible)
- intra-renal (intrinsic)
- post-renal (reversible)—BPH or doble stone blcoking bilat ureters
MCC of pre-renal AKI
renal hypoperfusion
intra-renal AKI
- define
- MCC
-disorders involving renal parenchymal or insterstitial tissue
ATN caused by ischemiia is MCC
decrease in blood suppply to the kidneys aka decr renal perfusion
Pre renal AKI