Renal Disease and Failure

Question 1

what is renal failure?

Answer 1

loss of kidney ability to excrete wastes, concentrate urine, conserve electrolytes, and maintain fluid balance

Question 2

when does acute renal failure set in?

Answer 2

hours to days

usually reversible

Question 3

when does chronic renal failure set in?

Answer 3

months to years

progresses slowly over time, affected parts can be compensated for by others

Question 4

what happens to GFR with age?

Answer 4

decreases

Question 5

what is the MDRD equation?

Answer 5

calculates GFR taking into consideration age and gender

Question 6

what is oliguria?

Answer 6

urine flow based on minimal urine volumes necessary to maintain balance

Question 7

what is anuria?

Answer 7

absent urine flow or less than 50ml per day

Question 8

microalbuminuria?

Answer 8

20-200 micfogram/min (30-300mg/day)

Question 9

proteinuria?

Answer 9

> 150mg/day

Question 10

azotemia?

Answer 10

increased amount of nitrogenous wastes present in urine

Question 11

uremia

Answer 11

fluid, electrolyte, and hormone imbalances and metabolic abnormalities associated with renal function deterioriation

Question 12

what are biomarkers for acute kidney injury?

Answer 12

creatine- increases with decreased GFR
interleukins
cystatin C- increases with decreased GFR

Question 13

what are the causes of renal injury?

Answer 13

ischemia
toxins
immune
sclerosis

Question 14

what are the responses of renal injury?

Answer 14

inflammation
necrosis
apoptosis
fibrosis
sclerosis

Question 15

what are the classes of glomerular injury?

Answer 15

nephritis

nephorsis

Question 16

what is nephritis?

Answer 16

hypertension, microscopic hematuria**, oliguria, azotemia, RBC casts in urine
mild proteinuria
inflammation
thickening of basement membrane

Question 17

what is nephrosis?

Answer 17

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)

Question 18

what are the characteristics of glomerulosclerosis?

Answer 18

thicker basement membrane
increased protein permeability
podocyte hypertrophy
effacement
increased ECF
mesangium degeneration

Question 19

what are the classes of acute renal failure?

Answer 19

prerenal
intrarenal
postrenal

Question 20

what are the characteristics of prerenal acute kidney failure?

Answer 20

caused by decreased vascular perfusion
decreased cortical RBF
causes: hypovolemia, hypotension, impaired cardiac function, NSAIDs, ACE inhibitors, liver disease, major surger

Question 21

what is intrarenal acute kidney disease?

Answer 21

caused by glomerular, interstitial, tubular, or vascular injury
often reversible 
caused by: tubular necrosis
prolonged ischemia
nephrotoxins

Question 22

what is post renal acute kidney disease?

Answer 22

obstruction of urine outflow

caused by ureteral or bladder obstruction

Question 23

what are characteristics of chronic renal failure?

Answer 23

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

Question 24

what are secondary characteristics of chronic renal failure?

Answer 24

protinuria***
phosphate retention
metabolic acidosis
anemia

Question 25

what are treatments for chronic kidney failure?

Answer 25

treat primary cause
corticosteroids
ACE inhibitor, AT2 receptor blocker
low fat and cholesterol diet