Renal disease Flashcards
The 3 main components of the renal tract are?
- kidneys
- ureter
- bladder
what are the 3 main functions of the renal system?
- excretory function
- acid base balance
- endocrine function
what is the function of erythropoietin?
to stimulate red blood cell production
what are the 3 endocrine functions of the renal system?
- produce erythropoietin
- activate vit D
- control blood pressure
what is polyuria?
abnormally large production of urine
what is oliguria?
abnormally small amount of urine produced
what is anuria?
the failure of the kidneys to produce urine
when blood is present in urine, this is called?
haematuria
proteinuria is when…
there is abnormally high protein levels detected in the urine
what is dysuria?
painful or difficult urination
A high urea content in urine is called..?
uraemia
hyperkalaemia is..?
high potassium content
dialysis is defined as…
renal replacement therapy
name the 4 ways to investigate the renal system.
- urine
- blood
- imaging
- tissue
what are the 3 tests that can be done to investigate the urine?
- dipstick
- microscopy
- microbiology
what will show up in the microscopy?
abnormal cells of crystals
what are the 4 things tested for in a dipstick test
- white blood cells
- blood
- protein
- glucose
name 3 electrolytes
- potassium
- urea
- ceratinine
what does GFR stand for?
glomerular filtration rate
what are 3 categories used to grade renal failure
- mild
- moderate
- severe
what are the GFR ranges of each of these categories?
mild = 20-50ml/min
moderate = 10-20 ml/min
severe =
4 ways to image the renal tract?
- plain radiograph
- intravenous urogram
- ultrasound
- MRI
what can hyperkalaemia cause?
cardiac arrest
if there is an excretion failure and uraemia occurs what are 6 possible consequences/signs? §
- malaise
- anorexia
- reduced immunity
- reduced platelet function
- itch
- eventually coma/death
what is it called when you have a life threatening acid-base balance possibly caused by renal disease?
acidosis
explain how a patient may get renal osteodystrophy?
renal failure = lack of vitamin D activation = bone disease in chronic situations
give 5 basic causes of renal failure.
- systemic disease
- hypovolaemia
- drugs
- infections
- obstruction
what are 5 systemic diseases that can commonly lead to renal failure?
- cancer
- diabetes
- hypertension
- atherosclerosis
- auto-immune (glomerulonephritis)
define hypovolaemia?
decreased volume of circulatory blood
what are 3 causes of hypovolaemia?
- massive haemorrhage
- sepsis
- O+V
name 4 drugs that can exacerbate pre-existing renal disease.
- NSAIDs
- tetracycline
- diuretics
- ACE inhibitors/angiotensin 2 blockers
name 4 possible obstructions that can cause renal failure?
- prostate
- stones
- abdominal or pelvic masses
- polycystic kidney disease
true or false - polycystic kidney disease is genetic.
True
what are the two forms of renal failure?
- acute
- chronic
what is acute renal failure defined as…
the RAPID LOSS of renal FUNCTION
what can the urine output be like in acute renal failure?
- normal
- low
- absent
what are the 4 things that make acute renal failure life threatening?
- hyperkalaemia
- uraemia
- fluid retention
- hypertension
is acute renal failure reversible?
yes often
how is ACUTE renal failure commonly brought about?
pre-exisiting diseased kidneys encounter an acute insult such as NSAIDs
3 stages of management of acute renal failure.
- identify and manage cause
- treat effects (K, fluid removal, replacement)
- dialysis - sometimes
what is chronic renal failure defined as?
gradual progression of renal impairment
what does ESRD stand for?
end stage renal disease
what is the GFR for ESRD?
5% of normal
what are 2 factors that influence the progression rate of CRF?
- underlying cause
- modifying factors
what are the 6 main causes of renal disease?
- diabetes
- hypertension
- atherosclerosis
- chronic renal infection
- polycystic kidney disease
- glomerulonephritis
what are the 4 effects of CRF?
- uraemia
- fluid retention
- lack of erythropoietin
- renal osteodystrophy
give 5 consequences of uraemia (high urea levels in blood)
- reduced immunity
- reduced platelet function
- malaise
- nausea
- itch
what are the two types of dialysis?
- haemodialysis (blood)
2. peritoneal dialysis
3 reasons why transplant is the optimal treatment for renal disease?
- normal renal function
- no dietary restrictions
- normal energy and fertility
3 issues with renal transplant are…
- rejection (acute or chronic)
- immunosuppresants required
- high cardiovascular mortality
what are two main disadvantages of immunosuppresants?
- increased infection risk
- increased risk of malignancy
what are 3 urinary tract diseases?
- urinary tract infections
- urinary tract obstruction
- urinary tract malignancy
which type of bacteria usually causes cystitis?
gram -ve bacilli ie E.coli
what are 4 main symptoms of UTI?
- dysuria
- frequency
- cloudy/offensive smelling urine
- suprapubic pain
2 forms of treatment for UTIs? -
- increased fluid intake
- antibiotics
what are the tests to detect a UTI?
- dipstick indicator
- microscopy, culture and sensitivity
what are 3 possible obstructions of the urinary tract?
- prostate
- renal calculi (stones)
- external compression (abdominal or pelvic malignancy)
what % of the population will experience renal calculi?
5%
what are the symptoms and treatment options for renal calculi?
Extremely painful!
- give them time to pass
- surgery
- lithotripsy (ultrasound shock waves)
what are the main dental aspects of renal disease?
- take care with prescribing NSAIDs
- growth/tooth eruption delayed in children = secondary to anaemia
- prone to post op infection/bleeding
- oral opportunistic infections/stomatitis
- renal osteodystrophy
- avoid regional blocks if severe bleeding tendency
- CRF = halitosis, dry mouth, metallic taste
- calculus accumulation
- oral ulceration due to anaemia
- secondary parathyroidism = giant cell lesion
- osseus lesions may occur
- salivary gland swelling
