Renal Disorders 3 Flashcards
Renal cyst
Cavity filled with fluid or renal tubular elements making up a semisolid material
How many categories of renal cysts?
6
Most common type of renal cysts
Polycystic kidney disease (PKD)
PKD is a leading cause of
ESRD
PKD requires
- dialysis
- transplantation
PKD: what causes it?
Genetic component
PKD: increased risk for
- HTN
- UTI
- certebral and aortic aneurysms
PKD: s/s
Same as other kidney disorders, but greatly enlarged
Upper urinary tract obstructions: slow growing
Tumors of the kidney may be slow growing without sx until they reach the point of impairment
Upper urinary tract obstructions: acute
Acute blockage by a stone (calculus) can result in abrupt, excruciating pain
Where do calculi develop?
- primarily develop in the kidney
- can stay here, or travel down the urinary tract and lodge at any point
Calculus formation =
Nephrolithiasis
Calculi are technically called this once they make their way to the ureter
Ureteral stones
(Kidney/ureteral) stones cause the most pain
Ureteral
Nephrolithiasis is the ___ most common urinary tract disorder __% of adults
3rd
5%
(Men/women) are more affected by nephrolithiasis
Men
nephrolithiasis: how is this formed?
Mineral deposits form inside the kidney
- calcium stones most common
- uric acid stones common in someone with gout
nephrolithiasis incidence is highest when?
Hot summer months
nephrolithiasis: size
Vary in shapes and sizes
S/s calculi
- severe, unilateral pain of side and back, groin, abd, etc
- murphy’s sign usu positive
- pain in waves and fluctuating intensity
- pain during urination
- hematuria
- cloudy or foul smelling urine
- N/V
- increased urge to urinate
- decreased voiding interval
- fever and chills if infection present
- small amts of urine
Hematuria =
Pink, red, or brown urine
What happens when there is a blockage?
urine accumulates proximal
Hydroureter =
Urine accumulates at level of ureter
Hydronephrosis
Urine accumulates above the ureter
Prevention of calculi
- get tests and go on meds if there’s some pathology discovered
- adequate fluid intake to decrease saturation of stone-forming crystals
- dietary mods according to stone type
Prevention of calculi: should be encouraged to drink enough water to achieve
Clear colored urine
Should a pt with calculi restrict calcium intake?
No, may be harmful
Medical tx of calculi: IV fluids
- meds to relieve N/V and pain
- BP meds to promote relaxation of ureter and increase liquid pressure
Medical tx of calculi: some require immed intervention to remove stone. When?
- anuria
- obstruction plus infection proximal to the stone
- unresponsive pain/vomiting
- solitary or transplanted kidney
If stones are of this size, can have shockwave lithotripsy
Less than 1 cm in proximal ureter
Shockwave lithotripsy =
- uses sound waves to break calculi into fragments
- broken down to the point that they can be spontaneously passed
What must be done if stones are more than 1 cm in proximal ureter?
Ureteroscopy
- pass a scope through urethra and bladder until reaching the stone
- laser passed through scope, tip placedo n stone, and laser is discharged
How are stones in the distal portion of the ureter treated?
- lithotripsy
- ureteroscopy
- medical expulsive therapy (flomax)
Common lower urinary tract conditions
- bladder tumors (most common site of urinary tract cancer)
- prostatic enlargement (either benign or malignant)
Prostatitis
Inflammation of the prostate causing prostate enlargement
How many types of prostatitis?
3
Causes of prostatitis
Unclear
Prostatitis: painful and can be exacerbated by
Sexual activity
Prostatitis: complaints
- voiding complaints similar to those of BPH
- may also have discomfort before, during, or after voiding
Dx stuff
- intravenous pyelogram (IVP) - dye injected and x-ray taken
- KUB radiograph (kidney, ureters, and bladder)
- renal artery doppler
