Renal Function Flashcards

1
Q

Kidney function

A
Excretion of metabolic waste products 
Regulation of water and electrolyte balance 
Regulation of acid-base balance 
Regulation of arterial blood pressure 
Secretion of hormones
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2
Q

Patho of the kidney

A

Filtration
Reabsorption
Secretion
Excretion

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3
Q

Filtration

A

Diffusion of plasma molecules across the glomerular membrane. 20% of plasma in glomulerus is filtered into globular capsule

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4
Q

Reabsorption

A

Diffusion or active transport of molecules in the urine filtrate from the renal tubules to the peritubular capillaries. Molecules reabsorbed include sodium, water, and glucose

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5
Q

Secretion

A

Active transport of plasma molecules to the filtrate in the renal tubules. Molecules secreted include potassium and hydrogen

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6
Q

Excretion

A

Any filtered molecule that is not reabsorbed + the secreted molecules are excreted in the urine

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7
Q

Clinical measures of renal function

A

Volume of fluid filtered (per minute) by the glomeruli in the kidneys

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8
Q

Plasma creating

A

Normally 110% of filtered creatinine is excreted, therefore decreased GFR results in an increased in plasma creatinine levels

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9
Q

Creatinine clearance

A

Can be calculated based on 24 hour urine collections or estimated using urine and plasma creatinine levels

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10
Q

Plasma blood urea nitrogen (BUN)

A

A reflection of plasma urea levels

Decreased GFR results in an increased in plasma BUN levels

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11
Q

Kidney stones

A

Aggregarates of crystals, protein or other substance as in the urinary tract. Also known as renal calculus, urinary stones, or urolithiasis

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12
Q

Patho of kidney stones

A

Supersaturation of calcium in urine filtrate leads to precipitation of small calcium based crystals.
Once the Indus has formed, the supersaturated urine causes larger stones

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13
Q

Consequences of kidney stones

A
Urinary tract obstruction 
Acute pain
Hematuria 
Hydronophrosis 
Chronic kidney disease
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14
Q

UTI

A

Inflammation of the bladder caused by infection, usually bacterial

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15
Q

Patho of a UTI

A

Bacterial contamination
Retrograde movement of bacteria from urethra to bladder
Inflammation leads to cystitis

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16
Q

Clinical manifestations of UTI

A
Asymptomatic 
Dysuria 
Frequency 
Suprapubic pain 
Fever
Urinalysis
17
Q

Complications of UTI

A

Acute pyelonephritis: upper ureter infection

Bacterium and sepsis: bacteria migrate into the bloodstream and cause a systemic inflammatory response

18
Q

Acute glomerulonephritis

A

Acute inflammation of the globular membrane caused by an autoimmune response to untreated group A beta-hemolytic streptococcal infection

19
Q

Primary etiology of Acute Glom

A

Untreated group A beta-hemolytic streptococcal infections

Can also lead to heart valve damage

20
Q

Patho of Acute glom

A

Antibodies against strep cross react with the glomerular endothelial cells
Inflammatory response causes damage to the glomerular endothelium as neutrophils try to phagocytosis the immune complexes and antibodies

21
Q

Clinical consequences and urinalysis findings in acute glom

A

Acute hemturia
Prteinuria
Oliguria

22
Q

Nephrotic syndrome

A

Excretion of 3 g or more or protein urine output

23
Q

Causes of NS

A
Glomerulonephritis 
Genetic mutations that cause alterations in the structure of the glomerular membrane 
Systemic diseases 
Drugs 
Infections
24
Q

Patho of nephrotic syndrome

A

Increased glomerular membrane permeability to protein leads to proteinuria
Hypoalbuminemia: results in decreased plasma oncotic pressure which can cause systemic edema

25
Q

Acute renal failure

A

Abrupt reduction in renal function usually associated with oliguria

26
Q

Prerenal acute failure

A

Caused by impaired renal blood flow
Causes: obstruction renal artery, hypotension
PathoL decreased glomerular pressures leads to decreased GFR and urine output

27
Q

Internal acute failure

A

Renal failure caused by direct injury to the glomerulus and renal tubules
Cause: acute glomerulonephritis , Malignant hypertension, Infection
Patho: ischemia or other direct injury to glomerulus and renal tubules

28
Q

Postrenal acute failure

A

Urinary tract obstruction that affects kidneys bilaterally
Cause: kidney stones, bladder outlet obstruction
Patho: obstruction causes increased pressures in glomerular capsule and back flow of urine filtrate

29
Q

Clinical consequences of acute renal failure

A
Oliguria 
Elevated creatinine, and BUN levels 
Elevated plasma K
Metabolic acidosis 
Fluid overload and hypertension
30
Q

Chronic renal failure

A

Progressive and loss of renal function
Cause: diabetes M, atherosclerosis of renal arteries, diabetic nephropathy, hypertension
Patho: increase creatinine
Anemia, hyperkalemia, acidosis, oliguria