Renal Failure

Question 1

Secretory function of kidney

Answer 1

EPO: regulate blood cell production
Vitamin D: regulate calcium uptake
Renin

Question 2

Presentation of CKD

Answer 2

Asymptomatic serum biochemical abnormality

Asymptomatic proteinuria or haematuria

Hypertension

Oedema

Symptoms of primary renal disease

Symptoms of uraemia

Complications of CkD

Question 3

General symptoms related to renal failure

Answer 3

• Tiredness
• Salt and water retention (oedema, hypertension, SOB, pulmonary oedema)
• Itching (uraemia etc)

Question 4

Factors causing progression of CKD

Answer 4

HYpertension
Proteinuria
Dyslipidaemia
Smoking
Age
Gender (m>f)
race
Diabetes control

Question 5

Causes of oedema

Answer 5

Heart failure
Renal failure
Liver failure
Hypoalbuminaemia

Question 6

Common causes of Pre-Renal AkI

Answer 6

Intravascular volume depletion (dehydration, haemorrhage)

Decreased cardiac output (congestive heart failure, infarct)

Systemic vasodilatation (anaphylactic shock, sepsis)

Question 7

What does kidney hypoperfusion result in

Answer 7

Renal ischaemia and low GFR

Question 8

What are the common causes of intrinsic AKI

Answer 8

Toxins or diseases which cause damage to small renal vessels and glomeruli- which commonly result in acute tubular necrosis

Question 9

Cause of post renal AKI

Answer 9

Acute obstruction of the flow of urine

Question 10

How does Post Renal AKI affect GFR

Answer 10

Increased pressure on the Bowman’s Capsule offers a resistance to normal filtration pressure

Question 11

What are consequences of acute kidney injury

Answer 11

Hyperkalaemia --> ECG abnormalities 
Decreased bicarbonate (metabolic acidosis)
Fluid overload 
Elevated urea
Elevated creatinine
Elevated uric acid 
Hypocalcaemia
Hyperphosphataemia