Renal anatomy + disease 2 Flashcards
Describe renal failure
A fall in GFR leading to an increase in serum urea and creatinine
What is GFR?
Glomerular filtration rate - the rate at which filtration occurs
Describe acute renal failure
Reversible
Describe chronic renal failure
Irreversible
Slow gradual fall in failure
Too late once symptoms have arisen
How do haemoglobin levels change in chronic renal failure?
Haemoglobin levels decrease
How does renal size change in chronic renal failure?
Renal size decreases
What is peripheral neuropathy?
Peripheral nerve damage leading to problems with sensation or movement
Describe uraemia
Glomerular membrane (endothelium and collagen layers) and podocyte cells thicken ->
Can lead to glomerulosclerosis, fibrosis, tubular atrophy and interstitial inflammation
->
Reduction in renal size
How does renal failure lead to hypertension, hyperkalemia and mild acidosis?
The kidney fails to excrete water and salt so the glomerular doesn’t filter properly ->
Sodium remains ->
Water and salt are retained causing hypertension ->
Plasma potassium levels remain high causing hyperkalaemia ->
H+ ions aren’t secreted so pH of body fluids decrease leading to mild acidosis
What symptoms does poor urea and creatinine excretion lead to?
Anorexia
Nausea
Vomiting
What symptoms does protein leaking into urine cause?
Neuropathy
Pericarditis (inflamed pericardium)
What does production failure of erythropoietin lead to?
Anaemia
Lethargy
What does erythropoietin do?
Regulates the production of red blood cells
What symptoms does failure to excrete phosphates cause?
Phosphate binds to plasma calcium leading to calcification (osteoporosis and osteomalacia)
Pruritus (itching)
What is a risk associated with dialysis?
Increased risk of death due to infection
What stage does uraemic syndrome set in?
At the moderate stage
What is the ‘normal’ GFR?
125ml/min
What are the most common causes of renal failure?
Glomerulonephritis
Diabetes mellitus
What is the mechanism for polycystic kidney disease?
Tubular structures are replaced by fluid filled cysts
Reduces the number of functional glomeruli
What are the 5 steps for prescribing treatment?
- Chronic vs acute
- Aetiology and severity (treat the cause)
- Treat reversible factors (diet, restricting protein, salt and water)
- Reduce symptoms (Phosphate binders/ Na bicarbonate/ Diuretics)
- Plan dialysis/ transplantation
