Renal Disease (IC) Flashcards
How many nephrons (working parts) are in each kidney?
About one million
What is inside a nephron?
A glomerulus (filtering unit) inside of which is a cluster of capillaries
How much ultrafiltrate is processed in the kidneys each day?
180L
Where does liquid waste travel from the kidneys?
To the bladder via ureters
How much liquid waste is excreted per day?
1.5L
What are the waste materials in urine?
Protein waste (urea, uric acid, creatinine, ammonia, and sulfates), excess water and nutrients, dead renal cells, and toxins
Oliguria eventually leads to what?
Renal failure
What urinary output is considered oliguric?
Under 500mL per day
What hormones do the kidneys produce?
The final form of vitamin D (calcitriol) and erythropoietin
What are some causes of kidney disorders?
Infection, diabetes, HTN, cysts, renal stones, or trauma
What are the symptoms of uremia?
Nausea, headache, convulsions, and coma
What are nephritis and glomerulonephritis?
General terms for renal inflammation
What is nephrosclerosis?
The hardening of renal arteries caused by arteriosclerosis and HTN, occurring in older people and diabetics
What is polycystic kidney disease?
A genetic condition which goes unnoticed until renal failure at roughly age fifty
What is nephrolithiasis?
Kidney stones– causes hematuria, infection, obstruction, and pain
What is the goal of dietary treatment for renal disease?
To decrease waste in the blood
Why should weight loss be prevented for renal clients?
Tissue is metabolized and circulated through the blood
What is often restricted in the diets of renal clients?
Protein, sodium, and often phosphorus and potassium
During stage 3-4 of renal disease, what may protein intake equal?
40g (no more than 3oz protein and 1/2c of milk)
What is the typical exchange diet for a client with stage 3-4 renal disease?
2 servings of 1/2c vegetables, 7 servings of grains, 5 servings of 1/2c fruit, and no more than 3oz protein and 1/2c milk
What types of fruits and vegetables should be consumed during renal treatment?
Low and moderate potassium
What are fluids and sodium limited during renal treatment?
Decrease edema and prevent hypertension and congestive heart failure
What nutrients are increased during renal treatment?
Calcium and vitamin D; sugar and fat for calories
Why is phosphorus decreased during renal treatment?
To prevent osteomalacia because it is often retained in renal clients
What proportion of diabetics develop kidney disease?
1/3 (30% T1D and 10-40% T2D develop ESRD)
Why is potassium restricted for renal clients?
Hyperkalemia tends to occur in ESRD, leading to MI (no salt subtitutes!)
What nutrients should be supplemented for renal disease?
vitamins B, C, and D, and iron to prevent anemia
Why should vitamin A not be given to renal clients?
In uremia, blood levels are increased already
How does hemodialysis work?
Using a permanent fistula near the wrist. 3 times a week for 3-5 hours
How does a peritoneal dialysis work?
Using the peritoneal cavity. 3 times a week for 10-12 hours (less efficient than hemodialysis)
How often is Continuous Ambulatory Peritoneal Dialysis (CAPD)?
Occurring 4-5x daily; 24 hour treatment
What are some complications associated with Continuous Ambulatory Peritoneal Dialysis (CAPD)?
Peritonitis, hypotension, and weight gain
What is the protein requirement during dialysis?
1.2g protein per kg of body weight
What percent of protein should be high biological value (HBV) from animal products for dialysis clients?
50%
How much potassium do healthy people ingest?
2,000-6,000mg
How much potassium should be ingested during renal failure (NOT ESRD)?
2,000-4,000mg
How much potassium should be ingested during ESRD?
1,500-2,500mg
Why is milk restricted to 1/2c or not allowed on renal diets?
High in potassium and methionine
What is the 80-3-3 diet?
For dialysis patients; 80g protein, 3g sodium, and 3g potassium
How many portions of protein are used on an 80-3-3 diet?
8 portions
How many portions of fat are used on an 80-3-3 diet?
Unrestricted
Which vitamins and minerals should be supplemented during dialysis?
Vitamins C + B to the DRI; Iron and D when blood levels are low
Which minerals may be given after a kidney transplant?
Calcium and phosphorus to undo bone loss
What percent of all renal stones are calcium oxalate?
80%
What are the risk factors for calcium oxalate stones?
Excessive animal protein or oxalates (in beets, bran, chocolate, tea, and strawberries); deficiencies of vitamin B6, thiamine, and magnesium
What is the treatment for uric acid stones?
Reduce purines (end products of nucleoprotein metabolism found in meat, alcohol, and broth) in the diet; medicate to reduce uric acid formation
What complications are associated with uric acid stones?
Gout, diarrhea, and malignant disease
How do cystine stones form?
From hereditary disorder; made up of amino acid
What is the dietary treatment for cystine stones?
Increase fluids and follow an alkaline-ash diet
What are struvite stones?
Magnesium ammonium phosphate buildup post UTI (called “infection stones”)
What is the dietary treatment for struvite stones?
Restrict phosphorus
