Renal Disease and Failure Flashcards
what is renal failure?
loss of kidney ability to excrete wastes, concentrate urine, conserve electrolytes, and maintain fluid balance
when does acute renal failure set in?
hours to days
usually reversible
when does chronic renal failure set in?
months to years
progresses slowly over time, affected parts can be compensated for by others
what happens to GFR with age?
decreases
what is the MDRD equation?
calculates GFR taking into consideration age and gender
what is oliguria?
urine flow based on minimal urine volumes necessary to maintain balance
what is anuria?
absent urine flow or less than 50ml per day
microalbuminuria?
20-200 micfogram/min (30-300mg/day)
proteinuria?
> 150mg/day
azotemia?
increased amount of nitrogenous wastes present in urine
uremia
fluid, electrolyte, and hormone imbalances and metabolic abnormalities associated with renal function deterioriation
what are biomarkers for acute kidney injury?
creatine- increases with decreased GFR
interleukins
cystatin C- increases with decreased GFR
what are the causes of renal injury?
ischemia
toxins
immune
sclerosis
what are the responses of renal injury?
inflammation necrosis apoptosis fibrosis sclerosis
what are the classes of glomerular injury?
nephritis
nephorsis
what is nephritis?
hypertension, microscopic hematuria**, oliguria, azotemia, RBC casts in urine
mild proteinuria
inflammation
thickening of basement membrane
what is nephrosis?
more pronounced proteinuria edema with low blood volume low serum albumin high serum cholesterol podocyte dysfunction glomerular sclerosis/fibrosis leaker filtration slits effacement (basement membrane separation)
what are the characteristics of glomerulosclerosis?
thicker basement membrane increased protein permeability podocyte hypertrophy effacement increased ECF mesangium degeneration
what are the classes of acute renal failure?
prerenal
intrarenal
postrenal
what are the characteristics of prerenal acute kidney failure?
caused by decreased vascular perfusion
decreased cortical RBF
causes: hypovolemia, hypotension, impaired cardiac function, NSAIDs, ACE inhibitors, liver disease, major surger
what is intrarenal acute kidney disease?
caused by glomerular, interstitial, tubular, or vascular injury often reversible caused by: tubular necrosis prolonged ischemia nephrotoxins
what is post renal acute kidney disease?
obstruction of urine outflow
caused by ureteral or bladder obstruction
what are characteristics of chronic renal failure?
permanent, large drop in GFR
irreversible
increased plasma creatinine
small kidneys
decreased plasma ca and increased phosphate
protinuria
most cases caused by diabetes and hypertension
what are secondary characteristics of chronic renal failure?
protinuria***
phosphate retention
metabolic acidosis
anemia
what are treatments for chronic kidney failure?
treat primary cause
corticosteroids
ACE inhibitor, AT2 receptor blocker
low fat and cholesterol diet
