Renal disease Flashcards
what is kidney disease?
partial or complete impairment of kidney function
what are 2 reasons for acute kidney injury?
abrupt decline in kidney function with
1) rise in serum creatinine
2) reduction in urine output
or both
is acute kidney injury reversible?
potentially
what are 3 types of acute kidney injury?
pre renal: reduction in circulation which then reduces renal blood flow
intra renal: direct damage to renal tissues
ex: acute tubular necrosis aka death of tissue
post renal: obstruction of urinary outflow
what are the key manifestations for acute kidney injury?
increase in creating and BUN
excess potassium
metabolic acidosis
what is the biggest complication with acute kidney injury?
hyperkalemia which results in dysrthmias
what if treatment doesnt fully work?
use crystalloids and diuretics in attempt to perfuse kidneys
what if treatment works?
fluid restriction to 600mL + previous 24 hours fluid loss
nutrition therapy
what are the 3 renal replacement therapies?
1) peritoneal dialysis
2) hemodialysis
3) continuous renal replacement therapy
what is chronic kidney disease?
irreversible loss of kidney function
GFR < 60ML for 3 months or longer
how long will the kidneys survive with chronic kidney disease?
can survive without replacement therapy until 90% of nephrons are lost
does chronic kidney disease go noticed or noticed?
usually goes unoticed because the little nephrons they are use hypertrophy to compensate
what are clinical manifestations of chronic kidney disease?
manifestations occur in all body systems
what are the chronic kidney disease diagnostic tests used?
protein to creatinine ratio in first morning voided specimen
what is dialysis?
movement of fluid and molecules across semi permeable membrane
what is diffusion, osmosis and ultrafiltration?
1) diffusion: movement of solutes from an area of greater concentration to an area of lesser concentration
2) osmosis: movement of fluid from an area of lesser to an area of greater concentration of solutes
3) ultrafiltration (water and fluid removal): occurs when there is an osmotic gradient or pressure across the membrane
what is peritoneal dialysis?
catheter inserted through anterior abdominal wall
- anchored in peritoneum to prevent migration of microorganisms
what are the 3 types of peritoneal dialysis?
1) inflow: prescribed amount of solution infused into catheter over about 10 times (usually 2L)
2) dwell: diffusion and osmosis occur between the patients blood and peritoneal cavity ( 20-30 minutes to 8 hours)
3) drain : takes approx 15-30min
then cycle repeats with 2L of fluid
what are some peritoneal dialysis complications?
common one is exit site infection
what is hemodialysis?
removing waste products and excess fluids from blood
what is required in hemodialysis?
rapid blood flow is needed in order to have access to a large blood vessel
what are the 2 types of hemodialysis?
1) arteriovenous fistulas and gifts (preferred bc of less complications)
2) central venous catheters
do pts gain weight on hemodialysis?
yes. usually 2-3kg between treatments. this fluid can be removed in the pt’s BP is stable throughout treatment
how long and often is hemodialysis performed?
treatment is 3-5 hours and minimum of 3x per week
