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Patho- Exam 3 > Renal Failure > Flashcards

Renal Failure Flashcards

1
Q

Acute Renal Failure also called

A

Acute Kidney Injury

-Rapid decrease in kidney function which causes collection of metabolic wastes in the body

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2
Q

3 types of AKI

A
  • prerenal
  • intrarenal
  • postrenal
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3
Q

prerenal AKI

A

-caused by reduced blow flow to the kidney

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4
Q

Intrarenal AKI

-causes damage to what three areas

A
  • caused by infections such as pyelonephritis, GN which caused damage to the glomeruli and interstitial tissue and tubules
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5
Q

postrenal AKI

- 2 causes

A

-caused by an obstruction of urine flow bc of stones or BPH- begnin prostatic hyperplasia

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6
Q

generalized possible caused of AKI

A
  • reduced blood flow like hypovolemic shock
  • toxins
  • infections
  • UT obstruction
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7
Q

Explain the process of kidney dysfunction

A

pressure in the kidney tubules intrarenal pressure exceeds glomerular pressure GFR stops and nitrogen wastes begin to collect in the blood (BUN and creatinine)
so when yup have the constant high BUN and Creatine this is kidney dysfunction

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8
Q

phaes of AKI

A
  • onset
  • oliguric
  • diuretic
  • recovery
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9
Q

how does the reduced blood flow to the kidney impact AKI

A
  • kidney compensates for the low perfusion of the kidneys
    -and compensates by constricting the renal blood vessels
    activating RAAS and releasing ADH
    -inc blood volume to the kidney
    -they reduce urine volume-oliguric phase
    -Azotemia- retention and buildup of nitrogen waste in the blood
    -nephron cell injury occurs due to lack of 02 (ischemia and reduced blood flow)
    -toxins case blood vessel constriction and reduce the kidney blood flow
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10
Q

Chronic Renal Failure

A
  • Progressive, irreversible disorder where kidney function does not recover
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11
Q

causes of Chronic Renal Failure

A
  • HTN- end organ damage of the kidney
  • DM- macrovascular changes of the kidney
  • Acute Renal Failure- if left untreated
  • Lupus
  • PKD
  • GN
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12
Q

How is Chronic Renal Failure Staged

A
  • based on the levels of GFR the lower the GFR the worse the kidney failure IS
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13
Q

What happens to CRF

A

-it becomes end stage kidney disease person dies

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14
Q

what kidney changes do we see in someone who has chronic kidney disease

A
  • the healthy nephrons become larger and try to work harder
  • GFR is going well until the 3/4 of the kidney function is lost then it becomes so low
  • abnormal urine production begins-poor water excretion
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15
Q

what metabolic changes do we see in someone who has CKD

A
  • urea and creatinine excretion are disrupted when the kidneys don’t work
  • when the kidneys are not working the creatnine levels increase in the blood
  • urea levels in the blood also inc for urea if kidneys don’t work
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16
Q

where do creatine come from

A

protein from skeletal muscle

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17
Q

when is urea made?

A

protein metabolism

18
Q

what happens to Na levels during early and late CKD

A
  • in early: there are not enough nephrons to absorb the Na and there is polyuria so alot of the Na is being pee-ed out
  • in Late CKD- there is oliguria and Na is kept in causing too much Na in the blood
19
Q

Potassium changes and CKD

A

in late stages there is going to hyperkalemia bc the kidneys dont work and none is being excreted
this causes fatal EKG changes and dyrthythmias

20
Q

acid base changes in CKD

A
  • in the easrly stages the nephrons that are working are removing H so there is not much difference
  • in the late stages- the kidneys cannot excrete the H so its acidic and Ammonia production is decreased. the kidneys also cannot reabsorb the HCO3 which makes reduced levels of bicarb
21
Q

Phosphate CKD

Ca

A

phosphate retention
vit d is not being activated
normally the kidneys would remove the excess phosphate and the PTH would control the P in the blood by causing tubular excretion of P
so low Ca and high P levels
the low Ca levels tell the PTH to take Ca out of the Bone (bone reabsorbtion) and this causes weak bones

22
Q

renal osteodystrophies

A

bone metabolism cause by CKD bc of the low Ca levels in the blood ad the high P levels

23
Q

HTN in CKD

A

-Na inc
-fluid overload
-dysfunction of RAAS
this is serve and worsens the kidney function
causes heart damage and enlargement

24
Q

hyperlipidema

A

changes in fat metabolism that increase LDL, Triglycerides, in risk for artherosclerosis and DM

25
Q

heart failure

A

anemia, HTN and fluid overload causes the increase burden on the heart
Heart failure
Uremic cardiomyopathy
left ventricular hypertrophy

26
Q

pericarditis

A

-pericardial sac is inflamed bc of the uremic toxins
-this can lead to effusion, tamponande, death
fluid around the heart makes it harder to hear
dysrthythmias
BP decreases SOB

27
Q

hematologic changes

A
  • bc there is no erythropoietin levels
    -uremia causes a dec in RBC survival time
    -iron and folic acid def
    increased bleeding
28
Q

GI changes

A
  • normal flora of the mouth changes
  • nausea
  • vomiting
  • hiccups
  • anorexia
  • mouth has urease which breaks down urea into ammonia and this can cause bad breath and inflammation of the mouth
  • peptic ulcer disease- unknown
29
Q

uremic cholitits

A

watery diarrhea

constipation

30
Q

why do some pple get a hemorrhagic shock from CKD

A
  • erosion of the blood vessels could cause a serve GI bleed
31
Q

Clinical manifestations of CKD neurological

A
  • lethargy
  • seizures
  • coma
  • sensory change
  • weakness in the extremities
32
Q

cardiovascular changes with CKD

A

-k induced dysarrthymias
-HTN
pericarditis
HF

33
Q

Respritory mani

A

uremic fetor- breath that smells like urine
SOB
Kussmal’s respirations bc of the acidosis
yawning
singing

34
Q

hematologic changes

A 
anemia
fatigue
pallor
weakness
SOB
dizziness
35
Q

GI

A

bad breath

mouth ulcers

36
Q

Skeletal

A

thin, fragile bones

loss of height

37
Q

urine

A

more dilute, clear bc the tubular reabsorption of water is reduced
in end stage there is oliguria so less pee

38
Q

skin

A

yellow bc of the uremia

39
Q

Treatment of end stage renal disease

A

Hemodialysis or peritoneal dialysis

40
Q

dialysis

A
  • removes waste products and excess fluids and restores the electrolyte balance to the blood
  • pass blood through the permeable membrane which filters it via diffusion
41
Q

deit changes

A

limit fluid
restrict- Na, K, P
Vitamins and minerals (iron, Ca, Vit D)
enough calories to meet needs

42
Q

Anemic treatments for those with

A

erthropoietin injections

Patho- Exam 3 (3 decks)

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