Renal Disorders Flashcards

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1
Q

Functions of the Renal System

A

Filters waste products

Regulations ion levels

Regulated blood pH

Conserves valuable nutrients

Regulates blood volume

Regulates RBC production

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2
Q

Glomerular Filtration Rate

A

Flow rate of filtered fluid (blood) through the kidney over time using creatinine clearance to estimate

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3
Q

Nephron

A

Functional unit of the kidney

  • Filtration
  • Tubular Reabsorption
  • Tubular Secretion
  • Excretion
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4
Q

Acute Kidney Injury

A

An abrupt decrease in renal function sufficient to cause retention of metabolic waste

Associated with:

  • Metabolic Acidosis
  • Hyperkalemia
  • Disturbance in fluid homeostasis
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5
Q

Oliguria

A

Daily urine output <400 mL

When present in acute renal failure … increased mortality

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6
Q

Anuria

A

No urine production (this is really, really bad…)

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7
Q

Most common community acquired ARF:

A

Prerenal (heart failure)

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8
Q

Most common hospital acquired ARF:

A

Acute Tubular Necrosis (ATN)

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9
Q

Causes of ARF: Pre-renal

A

Conditions that decrease RBF

  • Heart Failure
  • Shock
  • Sepsis
  • Hemorrhage
  • Hypovolemia
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10
Q

Causes of ARF: Post-renal

A

Conditions that obstruct and/or disrupt urine outflow

  • Kidney stones
  • Prostatic hypertrophy
  • Cancers of the bladder, prostate, or cervix
  • Blood clots
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11
Q

Causes of ARF: Intra-renal

A

Injury or inflammation to the kidneys

  • Interstitial nephritis
  • Acute glomerulonephritis
  • Acute tubular necrosis
  • Ischemia
  • Toxins
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12
Q

Urinary Drainage System Obstruction

A

Leads to dilation of urinary tract proximal to the obstruction

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13
Q

Chronic Renal Failure (CRF)

A

Diabetic Nephropathy

Hypertension

Glomerulonephritis

Polycystic Kidney Disease

Kidney Infections

Kidney Obstructions

Renal Vascular Disease

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14
Q

Chronic Renal Failure

A

Glomerular damage:

  • Fibrosis and wall thichening
  • Altered permeability

Sclerotic changes to renal blood supply

-Ischemia leads to tubular artophy and interstial fibrosis

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15
Q

Temporary Access (Hemodialysis)

A

A catheter is placed in a central vein, such as the internal jugular vein

Least durable

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16
Q

AV Fistula (Hemodialysis)

A

Surgeon constructs access by combining an artery and a vein

3 to 6 months to mature

17
Q

AV graft (Hemodialysis)

A

Man-made tube inserted by a surgeon to connect artery and vein

2 to 6 weeks to mature

Less durable than AV fistula

18
Q

Continuous Renal Replacement Therapy (CRRT)

A

Consists of continuous veno-venous or arterio-venous hemodialysis (like days…)

19
Q

Peritoneal Dialysis

A

Uses the peritoneum as the semipermeadble membrane and the diasylate is infused directly into the abdomen

Therapy is generally held during infusion and removal

20
Q

Dialysis Realted Problems

A

Hypovolemia

Lightheaded

Hypotension

Dysrhythmias

Disequilibration Syndrome

21
Q

Therapy Implications

A

Mobilization activities are typically contraindicated

Expect fluid and electrolyte imbalances (modify plan)

Expect potential dehydration, hypovolemia, hypotension, and fatigue

Monitor hemodynamic status and vitals

Avoid placement of blood pressure cuff over HD access