Renal Function, Acid-Base Disorders Flashcards
3 Metabolic Functions of the Kidneys
- activation of vitamin D
- gluconeogenesis
- metabolism of endogenous compounds (insulin and steroids)
3 Endocrine Functions of the Kidneys
- renin secretion
- erythropoietin secretion
- metabolism of prostaglandins and kinins
What is renin/what does it do?
- powerful regulator of BP
- plays a role in many types of HTN
What happens to EPO secretion with decreased renal mass? How can it be corrected?
- decreased renal mass = decreased EPO
- correct by giving EPOGEN
- decreased GFR –> decreased EPO –> anemia
What happens in glomerular filtration?
- passive diffusion of water and small molecules in Bowman’s capsule
- proteins not normally filtered
- in glomerular disease, lose selective process for filtering proteins
- protein is lost to the urine –> proteinuria
What happens with renal secretion?
-active transport in proximal tubule
What happens in renal reabsorption?
-reabsorption of water and solutes throughout the nephron
How is creatinine clearance measured?
- with 24 hr urine
- Cochroft Gault equation
What is a normal creatinine?
- normal range values can be misleading b/c it is based on pt’s weight
- normal is 0.7-1.2
What stage of renal dz are most patients in?
stage 3
At which stage of renal dz is dialysis started?
stage 5
What are the 4 primary acid-base disorders?
- metabolic acidosis
- metabolic alkalosis
- resp acidosis
- resp alkalosis
What acid-base disorders can never occur together?
-resp acidosis and resp alkalosis
What is the pH level used to determine acidosis vs. alkalosis?
pH > 7.4 = alkalosis
pH < 7.4 = acidosis
What acid-base condition is it if PCO2 is much less than 40 mmHg?
resp alkalosis
