Renal Failure Flashcards
A decrease in kidney funtion resulting in insufficient filtration of waste products from the blood
Renal failure
Acute insult that produces rapid loss of kidney function
Acute renal failure
Is acute renal failure reversible?
Yes
Progressive deterioration of kidney function
Chronic renal failure
Is chronic renal failure reversible
usually not
What determines renal failure?
A decrease in GFR
Reflected as a decrease or absence of urine
Reflected as a increase in was products Cr or Urea
Name 6 changes with renal failure
hematuria or proteinuria edema decreased calcium increased potassium increased phosphate anemia (later sign)
What contributes to anemia in renal failure
Compromise of renal function
Unable to release erythropoietin
reduces the number of blood cells per volume
Three underlying causes of renal failure
prerenal
intrarenal
postrenal
Indicates that the underlying cause is due to marked decrease in renal blood flow
Prerenal failure
Indicates that the underlying cause is damage to structures within the kidney
Intrinsic/Intrarenal failure
Indicates that the underlying cause is with problems with the urinary tract or outflow from the kidney
Postrenal failure
Most common form of acute renal failure
prerenal disease
What causes renal ischemia
systemic hypotension (heart failure, hypovolemia)
shock
other conditions that decrease renal perfusion
How does prerenal failure manifest?
oliguria and
a disproportionate elevation of BUN to CR ratio
Normal BUN/CR
10:1
BUN/Cr ratio in renal failure
moves to greater than 20:1
Is prerenal disease reversible?
Yes if the problem can be identified and corrected to restore blood flow before damage to kidney has occurred.
Causes of intrinsic renal failure
any disease that injures or damages structures within the kidney
glomerularnephritis
pyelonephritis
rhabdomyolysis
Most common cause of intrinsic renal disease
Acute Tubular Necrosis (ATN)
Involves release of myoglobin and can lead to ATN
rhabdomyolysis
Most common underlying cause of postrenal disease
Prostatic hyperplasia
Causes of postrenal failure
Obstruction of
ureter (calculi/strictures)
bladder (tumors or neurogenic)
urethra (prostatic hyperplasia)
most common cause of hyperkalemia
decreased renal function
diuresis, antagonist to aldosterone, increase water and Na excretion
ANP
CHF patients produce more of what?
ANP
therefor increase diuresis and decrease blood volume (BNP levels elevate)
Anemia in renal patients due to
low levels of erythropoietin
Hallmark with renal failure is
hypoalbuminemia
Increase BUN and Cr due to
decrease GFR
A powerful vasoconstrictor
Angiotensin II
The kidneys regulate vitamin D activity by
converting the inactive form of vitamin D to calcitriol, the active form
Five stages used to classify chronic kidney disease
Damage with normal or increase GFR Damage with mild decrease GFR Moderate decrease in GFR Severe decrease in GFR Kidney failure
Progressive loss of renal function over a period of months or years
Chronic kidney disease (CKD)
What happens in CKD?
destruction of renal tissue with irreversible sclerosis and loss of nephron function
Most common causes of CKD
diabetes mellitus
HTN
Glomerulonephritis
Treatments for CKD
dialysis
transplant
General condition of elevated serum levels of nitrogen-containing substances (urea, creatinine, and uric acid)
Azotemia
True or false: azotemia typically affect other systems in the body
False
it doesn’t affect other systems
Clinical syndrome of renal failure with azotemia where blood is not being filtered due to ARF
uremia
Accumulation of urea that causes a group of symptoms associated with renal failure
uremic syndrome
Uremia includes
azotemia acidosis hyperkalemia HTN anemia hypocalcemia
True or false: uremia can cause dysfunctions in other body systems
True
What is the difference between uremic syndrome and uremia?
Uremic syndrome only involves urea
Uremia is usually observed in what?
chronic kidney disease
