Renal Failure Flashcards
Two patterns of the loss of kidney filtration
Acute
Chronic
Stages of Chronic Kidney Disease
1 - GFR 90%+ 2 - GFR 60-89% 3 - GFR 30-59% 4 - GFR 15 - 29% 5 - GFR <15%
Diagnosis of Chronic Kidney Disease
Albuminuria
Imaging shows kidney structural changes
Electrolyte disturbances due to tubular dysfunction
GFR <60
Albuminuria Categories
A1 - <30
A2 - 30-300
A3 - >300
Creatinine Staging of Kidney Injury
1 - Cr 1.5 to 1.9 baseline of >0.3 increase
2 - 2.0 - 2.9 baseline
3 - 3x baseline (or more than 4.0)
These must also occur with low urine output
Prerenal v. Filtration v. Postrenal AKI
Prerenal - perfusion disruption (blood loss, etc.)
Filtration - Pathology of glomeruli or tubules
Postrenal - obstruction to rnal pelvis, ureters, bladder, urethrea
Symptoms of Renal Failure or Injury
Decreased GFR
Increased creatinine
Albumin in urine
Clinical symptoms are often vague or common with other diseases
Most common cause of AKI
Hospitalization with reduced perfusion and exposure to nephrotoxic medications
Stage 4 / 5 CKD
Must refer to nephrology! All CKD should be referred, but 4/5 will required dialysis
CKD Complications
Atherosclerosis Heart failure HTN Pulmonary edema Pericarditis N/V Anorexia electrolyte issues Anemia (Anemia of chronic disease)
Acute Renal Problem Symptoms
Oliguria (<400ml per day)
Edema
Confusion
Anorexia
Management of CKD
BP control is top priority (ACE-I) Diet - low protein Limit nephrotoxic drugs Smoking cessation Lipid Control