Renal Disease Flashcards
What are the primary roles of the Renin-Angiotensin-Aldosterone System (RAAS) in kidney function?
RAAS enhances sodium reabsorption in the proximal tubules and increases sodium and water reabsorption in the distal tubules, helping regulate blood pressure and fluid balance.
What is the significance of Glomerular Filtration Rate (GFR) in kidney function?
GFR is crucial for waste excretion. Failure to maintain GFR leads to waste accumulation (urea, creatinine), impaired pH control (acidosis, alkalosis), and issues with blood volume regulation, causing oedema.
What are the key causes of renal disease?
Hereditary: e.g., Adult Polycystic Kidney Disease (APKD)
Congenital: e.g., Horseshoe kidney
Infection: e.g., E. coli, Pyelonephritis, HUS
Autoimmune: e.g., Goodpasture’s syndrome
Immune complex: e.g., Post-streptococcal glomerulonephritis
Deposition disorders: e.g., Amyloidosis
Neoplasia: e.g., Wilms’ tumor
Secondary causes: e.g., Hypertension, endocarditis
What are the common symptoms and laboratory findings in Acute Renal Failure (ARF)?
Symptoms include oliguria (low urine output), hyperkalaemia, and metabolic acidosis. Laboratory findings show elevated urea and creatinine levels, indicating impaired waste excretion.
What is the pathophysiology of Chronic Renal Failure (CRF)?
CRF involves gradual nephron damage, leading to scarring and loss of kidney function. Compensatory hyperfiltration in remaining nephrons causes further damage, progressing the disease. It is irreversible, and controlling hypertension is key to slowing progression.
What are the biochemical markers of Chronic Renal Failure (CRF)?
Answer:
- High Urea (Uraemia) and Creatinine
- Hyperkalaemia (potassium retention)
- Hypocalcaemia
- Hyperphosphataemia
- Increased Parathyroid Hormone (PTH)
- Metabolic acidosis
What are the treatments for Chronic Renal Failure (CRF)?
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Haemodialysis
- Biochemical monitoring of U+E, calcium, phosphate
- Full Blood Count (FBC) for anaemia monitoring
- Erythropoietin (EPO) supplementation for anaemia
How does Renal Osteodystrophy develop in chronic kidney disease?
Renal Osteodystrophy occurs due to calcium loss and reduced Vitamin D, leading to secondary hyperparathyroidism. PTH increases bone breakdown, causing bone pain and structural changes.
What is the role of urinalysis in diagnosing renal disease?
Urinalysis detects abnormalities such as proteinuria, haematuria, and the presence of casts or crystals, indicating kidney dysfunction. It also helps monitor conditions like diabetic nephropathy and multiple myeloma.
What are the diagnostic indicators of Haemolytic Uraemic Syndrome (HUS) in renal disease?
HUS is characterized by E. coli infection (O157-H7), causing haemorrhagic colitis, renal failure, and high mortality rates. Diagnosis involves testing for verocytotoxin and managing with antibiotics and dialysis in ITU.
