Renal disorders Flashcards
what is CKD
gradual decline in GFR that progesses over a period of years
what things can cause prostate englargement
cancer
BPH (benign prostatic hyperplasisa)
Plasma creatinine relects GFR in what kind of kidney disease
Chronic
post renal failure is typically due to
obstruction of urine flow
what is the clinical standard of substances used to measure GFR
creatine
how can Ang II antagonists treat CFR
they allow the efferent arteriole to dilate and causes glomerular capillary pressure to fall back to normal
what percent of blood goes to the cortex
90
repeated upper UTIs can increase the risk for what
chronic kidney disease
what two things typically cause kidney stones
low fluid intake
dietary protein/sodium, oxalate, grapefruit juice (acidity)
is there typically hematuria with nephrotic syndrome
nada
what are the 3 categories of albuminuria
A1- microalbuminuria
A2 - macroalbuminuria
A3 - I cant find this term anywhere
why do men have a higher GFR
due to the higher Body Surface Area
what are a few treatment options for DKD
glycemic control
blood pressure control
(they reduce proteinuria_
how do you treat diabetic kidney disease
glycemic and BP control
what does VUR stand for
vesicouretheral reflux
what is minimal change disease
a form of nephrotic syndrome
what is a big structural injury due to DKD
podocyte loss or damage
what is the normal GFR range
90-120mL/min/1.73m^2
describe 2 clinical manifestations of DKD
progressive GFR decline
proteinuria
why is there a progressive decrease in GFR with DKD
due to structural damage
What is IgA nephropathy
a disease in which IgA protein builds up in and damages the glomerulus
End stage renal disease definition (RIFLE)
complete loss of kidney function for more than 3 montsh
what are 3 risks of proteinuria
kidney failure
heart disease
high blood pressure
what are 3 disorders caused by renal failure ONLY seen in CKD
anemia
bone disease
failiure to concentrate or dilate the urine
what is hydroureter
enlargement of the ureter due to a blockage
what does Pt stand for
tubular pressure
why is there early albuminuria and increase of GFR with DKD
due to a dysregulation of afferent/efferent arteriole constriction (due to vasoactive hormones)
Loss definition (RIFLE)
persistent AKI or complete loss of kidney function for more than 4 weeks
what is the formula for determinants of GFR
Kf (Pgc -(Pt +COPgc))
Injury definition (RIFLE)
doubling of creatinine or urine production under 0.5 ml/kg for 12 hours
what grade of VUR is the most vs lease severe
grade I - least severe
grade V - most severe
how many L of blood is filtered in 24 hours
180L
who is at a higher risk of collapsing glomerulopathy
those of sub saharan african descent
what is the most common cause od CKD
diabetic kidney disease
Nephritic syndrome
group of disorders that cause swelling or inflammation of the internal kidney structures
what is the RIFLE criteria used for
classifying acute kidney injury due to the degree of impairment present
why is albumin not filtered out
because both it AND the basement membrane of the glomerulus are negatively charged so they repel
what is collapsing glomerulopathy characterized by
segmental or global glomerular tuft collapse
GFR=
(Uin * V)/ Pin
decreased production of Ang II or receptor blockade causes what
the efferent arteriole to dilate
what are 4 treatments for kidney stones
chemolysis
diuretics
allopurinol to lower uric acid levels
removal of stones
what is snGFR
single nephron GFR
what does UFP stand for
net filtration pressure
does the glomerular capillary basement membrane have fixed negative or positive charges
negative
what is end stage renal disease
renal funciton is insufficient to maintain homeostasis
what cells tend to take the brunt of the injury in a lot of kidney diseases
podocytes
what occurs with minimal change disease
flapping of podocyte foot processes leads to over filtration
what is focal segmental glomerulosclerosis
only some glomeruli are damaged, and only a segment of those are damaged due to sclerosis
intrinsic renal failure factors with AKI are known as
primary renal failure
what are 4 typical UTI organisms
gram negative E coli
klebsiella
Proteus
staphylococcus saprophyticus (gram +)
what is the first change of structural injury with DKD
increase GBM width and increase in mesangial matrix deposisiton
what percent of blood goes to the medulla
1-2
what secretes creatinine
proximal tubules
molecules over what MW are not freely filtered
over 10 000MW
what are some symptoms of nephritic syndrome
hematuria
proteinuria
rapid reduciton in GFR
hypertension
what is the driving force for GFR
glomerular capillary hydrostatic pressure
what are the 3 substances used to measure GFR
inulin
Creatinine
Cystatin C
what is the most common kidney disease in children
minimal change disease
when do children reach adult GFR proportions
2 years old
what does RIFLE stand for
risk
Injury
failure
loss
end stage renal disease
Nephrotic syndrome
group of symptoms including proteinuria, low blood protein levels, high cholesterol, high triglyceride, and edema
what does Pgc stand for
glomerluar capillary pressrue
an increase in snGFR leads to
proteinuria
fibrosis leading to segmental flomerulosclerosis
what is secondary VUR
blockage causes an increase in pressure that pushes urine back up into the ureters
Kidney stones and prostate enlargement are both what kinds of kidney disorders
post renal
what are pre-renal failure usually related to
decreased perfusion, CHF or low BP
what is the range of normal plasma Cr
50-110 umol/L
how is VUR classified
as grade I through V
what is nephrolithiasis
kidney stones
what are the two types of VUR
primary and secondary
can CKD be reversed
nope :(
factors downstream of the kidney with AKI are known as
post-renal failure
plasma creatinine does not accurately reflect GFR in what kind of kidney disease
Acute kidney injury
what does FSGS stand for
focal segmental glomerulosclerosis
what is primary VUR
when the valve formed between the ureter and bladder doesn’t close properly leading urine reflux to the ureter and kidney
what is a primary glomerulopathy
a disorder taht affects glomerular structure/function in the absence of a multi-system disorder
what is AKI
sudden decrease in GFR to a level insufficient to maintain homeostasis
Ang II receptor stimulation contributes to what
the resistance of the efferent arteriole
what do primary glomerulophaties result in
proteinuria
hematuria
decreased GFR
what is the filtration barrier in the glomerulus
3-layered structure that allows small molecules to pass through while blocking larger ones
factors upstream of the kidney with AKI is known as
pre-renal failure
what is collapsing glomerulopathy
aggressive and distinct histologic variant of FSGS
name some causes of nephrotic syndrome
FSGS
congenital conditions
diabetic kidney disease
minimal change disease
VUR caused by a physical defect typically results from what
an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder
what does Kf stand for
ultrafiltration coefficient
what are the 3 parts of the filtration barrier
fenestrated endothelial cells
glomerular basement membrane
podocytes
Failure definition (RIFLE)
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
functional vs structural injury
Functional kidney injuries are reversible with early treatment, while structural kidney injuries are not.
what is the GFR
rate at which plasma moves through the golmerular capillaries
intrinsic renal failure is usually due to
toxins, obstructions to blood flow, RPGN
how can minimal change disease be treated
steroids
name 5 causes of CKD
diabetes
hypertension
FSGS
genetic mutations
immune disorders
what can VUR lead to
CKD
what does COP stand for
colloid osmotic pressure
what are kidney stones made out of
calcium oxalate
struvite
uric acid
etc
what is hydronephrosis
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
what two main things cause nephritic syndrome
infection or immune system
what is membranous nephropathy
an autoimmune disease that causes inflammation and changes in the kidney’s filtering structures
Risk definition (RIFLE)
serum creatinine increased 1.5 times or urine production of under 0.5ml/kg for 6 hours
what kind of UTI is afebrile
lower
what is the typical amount of renal blood flow
1200ml/min
what kind of UTI is febrile
upper
what are three clinical manifestations of functional injury due to DKD
early microalbuminuria
increased GFR
progressive decrease in GFR
many CKD forms involve what
glomerular injury
what is the gold standard of substances used to measure GFR
inulin
name 8 disorders caused by renal failure
hyperkalemia
edema
hypertension
metabolic acidosis
uremia
anemia
bone disease
failure to concentrate or dilate the urine
what is lithotripsy
medical procedure that breaks up kidney stones using shock waves or a laser
