Renal Conditions Flashcards
What is Pyelonephritis?
upper UTI, kidney infection
Pyelonephritis means
inflammation of the kidneys
Causes of pyelonephritis
ascending infection (most common)
bloodstream infection (less common)
Risk factors for pyelonephritis
pregnancy, recurrent lower UTIs, antibiotic resistant strain
Untreated or recurrent pyelonephritis can lead to
abscesses, necrosis, permanent kidney damage (CKD), sepsis
Pyelonephritis manifestations (7)
Sudden onset
Fever/chills
CVA tenderness
Lower UTI symptoms (dysuria)
Hematuria may be present
N/V
Anorexia
Antibiotics used to commonly treat pyelonephritis
Bactrim, ciprofloxacin, nitrofuritonin (Macrobid)
What is urosepsis
sepsis caused by a UTI (upper or lower)
Urosepsis is more common in what population?
the ederly
Urinary obstructions can occur at the
renal pelvis
ureter
bladder/urethra
Cause of urinary obstruction at the renal pelvis
renal calculi (kidney stones)
Cause of urinary obstruction at the ureter
renal calculi
pregnancy
tumor
Cause of urinary obstruction at the bladder and urethra
Prostatic hyperplasia
Prostate cancer
Bladder cancer
Neurogenic bladder
Urethral strictures
A urinary obstruction causes back up of urine and increased pressure in the ureter resulting in
hydroureter
A urinary obstruction causes back up of urine and increased pressure in the kidney resulting in
Hydronephrosis
Manifestations of acute obstruction depend on (3)
site
cause (kidney stones, prostate issue)
speed of onset
Which factor determines the severity of pain of a urinary obstruction?
Speed of onset
Acute onset = more painful
Slow onset (like a prostate issue) = body has time to adjust and the pain is less severe
Site of a stone: pain in the renal pelvis is ____ severe than pain in the ureter because the ureters are ____ and ____ difficult for the stone to pass through
Less; smaller; more
Nephroliathis
Renal calculi or ‘Kidney Stones”
Definition: clumps of crystals in the urinary tract
Most common cause of urinary obstruction
Renal calculi (Kidney Stones)
Renal calculi crystal begin forming in the
NEPHRON
Renal calculi crystal formation is enhanced by
PH changes -UTI
Excessive concentration of insoluble salts in the urine – dehydration, bone disease, gout, renal disease
Urinary Stasis - immobility/sedentary lifestyle
Nephroliathis risk factors
Sex: Men
Age: 20s – 30s
Race: white
Family history
Congenital defect of the urinary tract
Hot weather
Obesity
Most common type of kidney stone
calcium oxalate, calcium phosphate
Specific risks for calcium oxalate/phosphate stones
Mostly idiopathic
Family history
↑ Calcemia intake
↑ Oxaluria intake
↑ Protein intake
Specific risks for struvite (staghorn) stones
urinary tract infections
Specific risks for uric acid/urate stones
gout
Pain of acute “renal colic”
location – flank
radiation – lower abd and groin
spasms – “colicky” last 20-60 minutes
intermittent - ureter spasms
sharp - calculi scrape the ureter wall
Accompanying symptoms of renal colic (besides pain)
N/V
Dysuria
Chills, Fever (ONLY if infection is present)
Hematuria
Foul smelling urine
Diaphoresis
Nephrolithiasis pharmacotherapy for ACUTE PAIN
morphine, NSAIDS
IV fluids
Nephrolithiasis pharmacotherapy for PREVENTION
Calcium = thiazide diuretics
Struvite = antibiotics
Urate = allopurinol
