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PHS 3300 > Renal disorders > Flashcards

Renal disorders Flashcards

1
Q

what is renal blood flow

A

1200ml/min

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2
Q

what percent of blood goes to the cortex

A

90

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3
Q

what percent of blood goes to the medulla

A

1-2

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4
Q

how many L of blood is filtered in 24 hours

A

180L

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5
Q

when do children reach adult GFR proportions

A

2 years old

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6
Q

what is the GFR

A

rate at which plasma moves through the golmerular capillaries

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7
Q

why do men have a higher GFR

A

due to the higher Body Surface Area

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8
Q

what is the driving force for GFR

A

glomerular capillary hydrostatic pressure

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9
Q

what is the formula for GFR

A

Kf (Pgc -(Pt +COPgc))

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10
Q

what does Kf stand for

A

ultrafiltration coefficient

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11
Q

what does Pgc stand for

A

glomerluar capillary pressrue

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12
Q

what does Pt stand for

A

tubular pressure

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13
Q

what does COP stand for

A

colloid osmotic pressure

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14
Q

what does UFP stand for

A

net filtration pressure

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15
Q

what is the gold standard of substances used to measure GFR

A

inulin

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16
Q

what is the clinical standard of substances used to measure GFR

A

creatine

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17
Q

what are the 3 substances used to measure GFR

A

inulin
Creatinine
Cystatin C

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18
Q

GFR=

A

(Uin * V)/ Pin

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19
Q

what secretes creatinine

A

proximal tubules

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20
Q

what is the range of normal plasma Cr

A

50-110 umol/L

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21
Q

Plasma creatinine relects GFR in what kind of kidney disease

A

Chronic

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22
Q

plasma creatinine does not accurately reflect GFR in what kind of kidney disease

A

Acute kidney injury

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23
Q

what is the normal GFR range

A

90-120mL/min/1.73m^2

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24
Q

what is AKI

A

sudden decrease in GFR to a level insufficient to maintain homeostasis

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25
Q

factors upstream of the kidney with AKI is known as

A

pre-renal failure

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26
Q

intrinsic renal failure factors with AKI are known as

A

primary renal failure

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27
Q

factors downstream of the kidney with AKI are known as

A

post-renal failure

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28
Q

what are pre-renal failure usually related to

A

decreased perfusion, CHF or low BP

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29
Q

intrinsic renal failure is usually due to

A

toxins, obstructions to blood flow, RPGN

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30
Q

post renal failure is typically due to

A

obstruction of urine flow

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31
Q

what is the RIFLE criteria used for

A

classifying acute kidney injury due to the degree of impairment present

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32
Q

what does RIFLE stand for

A

risk
Injury
failure
loss
end stage renal disease

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33
Q

Risk definition (RIFLE)

A

serum creatinine increased 1.5 times or urine production of under 0.5ml/kg for 12 hours

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34
Q

Injury definition (RIFLE)

A

doubling of creatinine or urine production under 0.5 ml/kg for 12 hours

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35
Q

Failure definition (RIFLE)

A

tripling of creatinine or creatinine under 355 umol/L (with a rise of over 44) (over 4mg/dl) OR urine output below 0.3ml/kg for 24 hours

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36
Q

Loss definition (RIFLE)

A

persistent AKI or complete loss of kidney function for more than 4 weeks

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37
Q

End stage renal disease definition (RIFLE)

A

complete loss of kidney function for more than 3 montsh

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38
Q

Kidney stones and prostate enlargement are both what kinds of kidney disorders

A

post renal

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39
Q

what is nephrolithiasis

A

kidney stones

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40
Q

what are kidney stones made out of

A

calcium oxalate
struvite
uric acid
etc

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41
Q

what things can cause prostate englargement

A

cancer
BPH (benign prostatic hyperplasisa)

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42
Q

what two things typically cause kidney stones

A

low fluid intake
dietary protein/sodium, oxalate, grapefruit juice (acidity)

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43
Q

what are 4 treatments for kidney stones

A

chemolysis
diuretics
allopurinol to lower uric acid levels
removal of stones

44
Q

what is lithotripsy

A

medical procedure that breaks up kidney stones using shock waves or a laser

45
Q

what is hydronephrosis

A

condition where one or both kidneys become stretched and swollen due to a build of urine inside them

aka build up of fluid in the kidye

46
Q

what is hydroureter

A

enlargement of the ureter due to a blockage

47
Q

what are 4 typical UTI organisms

A

gram negative E coli
klebsiella
Proteus
staphylococcus saprophyticus (gram +)

48
Q

what kind of UTI is febrile

A

upper

49
Q

what kind of UTI is afebrile

A

lower

50
Q

repeated upper UTIs can increase the risk for what

A

chronic kidney disease

51
Q

what are the two types of VUR

A

primary and secondary

52
Q

what does VUR stand for

A

vesicouretheral reflux

53
Q

what is primary VUR

A

when the valve formed between the ureter and bladder doesn’t close properly leading urine reflux to the ureter and kidney

54
Q

what is secondary VUR

A

blockage causes an increase in pressure that pushes urine back up into the ureters

55
Q

how is VUR classified

A

as grade I through V

56
Q

what grade of VUR is the most vs lease severe

A

grade I - least severe
grade V - most severe

57
Q

VUR caused by a physical defect typically results from what

A

an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder

58
Q

what can VUR lead to

A

CKD

59
Q

what is CKD

A

gradual decline in GFR that progesses over a period of years

60
Q

what is end stage renal disease

A

renal funciton is insufficient to maintain homeostasis

61
Q

can CKD be reversed

A

nope :(

62
Q

name 5 causes of CKD

A

diabetes
hypertension
FSGS
genetic mutations
immune disorders

63
Q

many CKD forms involve what

A

glomerular injury

64
Q

what is the filtration barrier in the glomerulus

A

3-layered structure that allows small molecules to pass through while blocking larger ones

65
Q

what are the 3 parts of the filtration barrier

A

fenestrated endothelial cells
glomerular basement membrane
podocytes

66
Q

molecules over what MW are not freely filtered

A

over 10 000MW

67
Q

does the glomerular capillary basement membrane have fixed negative or positive charges

A

negative

68
Q

why is albumin not filtered out

A

because both it AND the basement membrane of the glomerulus are negatively charged so they repel

69
Q

what cells tend to take the brunt of the injury in a lot of kidney diseases

A

podocytes

70
Q

what are 3 risks of proteinuria

A

kidney failure
heart disease
high blood pressure

71
Q

what is a primary glomerulopathy

A

a disorder taht affects glomerular structure/function in the absence of a multi-system disorder

72
Q

what do primary glomerulophaties result in

A

proteinuria
hematuria
decreased GFR

73
Q

Nephrotic syndrome

A

group of symptoms including proteinuria, low blood protein levels, high cholesterol, high triglyceride, and edema

74
Q

Nephritic syndrome

A

group of disorders that cause swelling or inflammation of the internal kidney structures

75
Q

what are the 3 categories of albuminuria

A

A1- microalbuminuria
A2 - macroalbuminuria
A3 - I cant find this term anywhere

76
Q

is there typically hematuria with nephrotic syndrome

A

nada

77
Q

name some causes of nephrotic syndrome

A

FSGS
congenital conditions
diabetic kidney disease
minimal change disease

78
Q

what does FSGS stand for

A

focal segmental glomerulosclerosis

79
Q

what is focal segmental glomerulosclerosis

A

only some glomeruli are damaged, and only a segment of those are damaged due to sclerosis

80
Q

what is minimal change disease

A

a form of nephrotic syndrome

81
Q

what is the most common kidney disease in children

A

minimal change disease

82
Q

what occurs with minimal change disease

A

flapping of podocyte foot processes leads to over filtration

83
Q

how can minimal change disease be treated

A

steroids

84
Q

what is the most common cause od CKD

A

diabetic kidney disease

85
Q

how do you treat diabetic kidney disease

A

glycemic and BP control

86
Q

describe 4 parts of DKD

A

progressive GFR decline
proteinuria
increased BP
increased risk of CV disease

87
Q

functional vs structural injury

A

Functional kidney injuries are reversible with early treatment, while structural kidney injuries are not.

88
Q

what are three clinical manifestations of functional injury due to DKD

A

early microalbuminuria
increased GFR
progressive decrease in GFR

89
Q

why is there a progressive decrease in GFR with DKD

A

due to structural damage

90
Q

what is the first change of structural injury with DKD

A

increase GBM width and increase in mesangial matrix deposisiton

91
Q

why is there early albuminuria and increase of GFR with DKD

A

due to a dysregulation of afferent/efferent arteriole constriction (due to vasoactive hormones)

92
Q

what is a big structural injury due to DKD

A

podocyte loss or damage

93
Q

what are a few treatment options for DKD

A

glycemic control
blood pressure control
(they reduce proteinuria_

94
Q

what two main things cause nephritic syndrome

A

infection or immune system

95
Q

what are some symptoms of nephritic syndrome

A

hematuria
proteinuria
rapid reduciton in GFR
hypertension

96
Q

What is IgA nephropathy

A

a disease in which IgA protein builds up in and damages the glomerulus

97
Q

what is membranous nephropathy

A

an autoimmune disease that causes inflammation and changes in the kidney’s filtering structures

98
Q

name 8 disorders caused by renal failure

A

hyperkalemia
edema
hypertension
metabolic acidosis
uremia
anemia
bone disease
failure to concentrate or dilate the urine

99
Q

what are 3 disorders caused by renal failure ONLY seen in CKD

A

anemia
bone disease
failiure to concentrate or dilate the urine

100
Q

Ang II receptor stimulation contributes to what

A

the resistance of the efferent arteriole

101
Q

decreased production of Ang II or receptor blockade causes what

A

the efferent arteriole to dilate

102
Q

how can Ang II antagonists treat CFR

A

they allow the efferent arteriole to dilate and causes glomerular capillary pressure to fall back to normal

103
Q

an increase in snGFR leads to

A

proteinuria
fibrosis leading to segmental flomerulosclerosis

104
Q

what is snGFR

A

single nephron GFR

105
Q

what is collapsing glomerulopathy

A

aggressive and distinct histologic variant of FSGS

106
Q

what is collapsing glomerulopathy characterized by

A

segmental or global glomerular tuft collapse

107
Q

who is at a higher risk of collapsing glomerulopathy

A

those of sub saharan african descent

PHS 3300 (14 decks)

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