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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
List some dermatological clinical features that may arise from Chronic Kidney Disease (3)
- Pruritus (itching skin) - Bruising - Infections
26
How would you investigate Chronic Kidney Disease? (5)
- Urine examination - Full blood count - Biochemistry - Renal ultrasound - Renal biopsy
27
What may you see from a full blood count to suggest Chronic Kidney Disease? (2)
- Decrease in RBC (Anaemia) | - Impaired platelet function
28
What changes to a patients biochemistry may you see when investigating Chronic Kidney Disease? (3)
- Increase in urine and creatine - Increase in potassium and metabolic acidosis - Increase in phosphate and PTH
29
What may you see from an urine examination to suggest Chronic Kidney Disease? (3)
- Red cell casts - White cell casts - Urate crystals
30
For Chronic Kidney Disease how would you treat the symptom of hypertension?
ACE inhibitors
31
For Chronic Kidney Disease how would you treat the symptom of fluid retention?
Diuretics
32
For Chronic Kidney Disease how would you treat the symptom of Hyperphosphataemia?
Calcium carbonate
33
For Chronic Kidney Disease how would you treat the symptom of hypoglycaemia?
Calcium supplements
34
For Chronic Kidney Disease how would you treat the symptom of metabolic acidosis?
Sodium bicarbonate
35
What does dialysis help remove?
Removes metabolites and excess water
36
Name some side effects of dialysis (4)
- Hypoxaemia - Haemolysis - Hypotension - Cramps
37
What are the 2 types of dialysis?
- Peritoneal dialysis | - Haemodialysis
38
Which dialysis can be carried out at home?
Peritoneal dialysis
39
Which dialysis is more effective?
Haemodialysis
40
How long and how frequent is Haemodialysis carried out?
3 times a week for 3 hours each session
41
What are some potential complications of Renal transplants? (3)
- Transplant rejection - Immunosuppression induced infection or malignancy - Increased risk of ischaemic heart disease
42
What is the dental relevance of Chronic Kidney Disease? (5)
- 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
What is the dental relevance of renal transplantation? (5)
- 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
What is Nephrotic Syndrome?
Glomerular damage resulting in classical triad of; - Massive proteinuria - Hypoalbuminemia - Oedema
45
What are risk factors of What is Nephrotic Syndrome?
Major risk factors are conditions that can damage the kidney e.g. diabetic nephropathy, SLE, Amyloidosis
46
What are some clinical features of nephrotic syndrome?
- Facial and pedal oedema - Ascites - Weight gain - Fatigue - Loss of appetite

BDS 2: CHHD (28 decks)

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