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BDS 2: CHHD > Renal Diseases > Flashcards

Renal Diseases Flashcards

1
Q

What are the specialised functions of the kidney? (4)

A
  • Excretion of many metabolites and drugs
  • Regulation of body fluid and electrolyte balance
  • Regulation of acid-base balance
  • Endocrine functions
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2
Q

Kidneys receive __% of blood volume per minute

A

25%

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3
Q

Through what mechanism does the kidney reclaim useful materials such as glucose and amino acids?

A

Selective reabsorption

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4
Q

In the PCT what controls the active transport of Na+?

A

Angiotensin II

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5
Q

In the PCT active transport of phosphate is suppressed by what?

A

PTH

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6
Q

What substances are reabsorbed at the PCT? (4)

A
  • Glucose
  • Amino acids
  • Uric acid
  • Inorganic Salts
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7
Q

Renin-Angiotensin-Aldosterone system

A
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8
Q

What are 2 sources of Vitamin D? (2)

A
  • Skin exposure to UVB

- Diet supplement

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9
Q

What is calcitriol?

A

Active form of vitamin D in the body

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10
Q

What are the pre-renal factors of acute renal failure? (4)

A
  • Hypotension
  • Renal thrombosis
  • Sepsis
  • Drugs causing renal shutdown
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11
Q

What are the renal factors of acute renal failure? (4)

A
  • Antibiotics
  • Analgesic overdose
  • Multiple organ failures most often due to trauma or sepsis
  • Interstitial nephritis
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12
Q

What is a post-renal factor of acute renal failure?

A

Obstructed urine flow

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13
Q

How do you manage acute renal failure?

A

Dialysis

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14
Q

What may arise from acute renal failure? (3)

A
  • Confusion
  • Seizure
  • Coma
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15
Q

What is Chronic Kidney Disease characterised by?

A

Characterised by the presence of kidney damage or reduction in GFR (< 90ml/min) for 3 or more months

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16
Q

What are the five stages of Chronic Kidney Disease?

A
  • Early
  • Mild
  • Moderate
  • Severe
  • End-stage
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17
Q

Name some common causes of Chronic Kidney Disease (7)

A
  • Long standing Hypertension
  • Diabetes Mellitus
  • Chronic pyelonephritis
  • Chronic glomerulonephritis
  • Polycystic renal disease
  • Urinary tract obstruction
  • Renal artery stenosis
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18
Q

Name some less common causes of Chronic Kidney Disease (6)

A
  • Systemic Lupus Erythematosus
  • Amyloid
  • Multiple Myeloma
  • Gout
  • Lead poisoning
  • Long-term use of drugs
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19
Q

When do symptoms of Chronic Kidney Disease start too manifest?

A

When kidney function has fallen below 25%

20
Q

List some blood and immune clinical features that may arise from Chronic Kidney Disease (3)

A
  • Anaemia
  • Bleeding tendencies
  • Lymphopenia (susceptibility to infection)
21
Q

List some metabolic clinical features that may arise from Chronic Kidney Disease (4)

A
  • Increase in nitrogenous compounds
  • Renal osteodystrophy
  • Vitamin D deficiency
  • Polyuria, Polydipsia, Glycosuria
22
Q

List some gastrointestinal clinical features that may arise from Chronic Kidney Disease (2)

A
  • Anorexia

- Nausea and vomiting

23
Q

List some meuromuscular clinical features that may arise from Chronic Kidney Disease (5)

A
  • Headaches
  • Confusion
  • Sensory disturbances
  • Tremors
  • Peripheral neuropathy
24
Q

List some cardiovascular clinical features that may arise from Chronic Kidney Disease (4)

A
  • Hypertension
  • Congestive cardiac failure
  • Atheroma
  • Peripheral vascular disease
25
Q

List some dermatological clinical features that may arise from Chronic Kidney Disease (3)

A
  • Pruritus (itching skin)
  • Bruising
  • Infections
26
Q

How would you investigate Chronic Kidney Disease? (5)

A
  • Urine examination
  • Full blood count
  • Biochemistry
  • Renal ultrasound
  • Renal biopsy
27
Q

What may you see from a full blood count to suggest Chronic Kidney Disease? (2)

A
  • Decrease in RBC (Anaemia)

- Impaired platelet function

28
Q

What changes to a patients biochemistry may you see when investigating Chronic Kidney Disease? (3)

A
  • Increase in urine and creatine
  • Increase in potassium and metabolic acidosis
  • Increase in phosphate and PTH
29
Q

What may you see from an urine examination to suggest Chronic Kidney Disease? (3)

A
  • Red cell casts
  • White cell casts
  • Urate crystals
30
Q

For Chronic Kidney Disease how would you treat the symptom of hypertension?

A

ACE inhibitors

31
Q

For Chronic Kidney Disease how would you treat the symptom of fluid retention?

A

Diuretics

32
Q

For Chronic Kidney Disease how would you treat the symptom of Hyperphosphataemia?

A

Calcium carbonate

33
Q

For Chronic Kidney Disease how would you treat the symptom of hypoglycaemia?

A

Calcium supplements

34
Q

For Chronic Kidney Disease how would you treat the symptom of metabolic acidosis?

A

Sodium bicarbonate

35
Q

What does dialysis help remove?

A

Removes metabolites and excess water

36
Q

Name some side effects of dialysis (4)

A
  • Hypoxaemia
  • Haemolysis
  • Hypotension
  • Cramps
37
Q

What are the 2 types of dialysis?

A
  • Peritoneal dialysis

- Haemodialysis

38
Q

Which dialysis can be carried out at home?

A

Peritoneal dialysis

39
Q

Which dialysis is more effective?

A

Haemodialysis

40
Q

How long and how frequent is Haemodialysis carried out?

A

3 times a week for 3 hours each session

41
Q

What are some potential complications of Renal transplants? (3)

A
  • Transplant rejection
  • Immunosuppression induced infection or malignancy
  • Increased risk of ischaemic heart disease
42
Q

What is the dental relevance of Chronic Kidney Disease? (5)

A
  • Dental treatment is best suited for the day after dialysis
  • Ensure careful haemostasis during surgical procedures
  • Odontogenic infection should be treated promptly
  • Prescription of drugs excreted mainly by the kidney needs to be adjusted post consultation with a renal physician
  • Avoid systemic fluorides, aspirin and NSAIDs
43
Q

What is the dental relevance of renal transplantation? (5)

A
  • Patients taking steroids may need steroid cover for stressful procedures
  • Transplant patients on immunosuppressants more susceptible to infection
  • Transplant patients must carefully monitored and aggressively treated for infections
  • Higher risk of gingival hyperplasia
  • Higher risk of tuberculosis
44
Q

What is Nephrotic Syndrome?

A

Glomerular damage resulting in classical triad of;

  • Massive proteinuria
  • Hypoalbuminemia
  • Oedema
45
Q

What are risk factors of What is Nephrotic Syndrome?

A

Major risk factors are conditions that can damage the kidney e.g. diabetic nephropathy, SLE, Amyloidosis

46
Q

What are some clinical features of nephrotic syndrome?

A
  • Facial and pedal oedema
  • Ascites
  • Weight gain
  • Fatigue
  • Loss of appetite

BDS 2: CHHD (28 decks)

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