renal function (chem version)

Question 1

generally describe glomerular disease

Answer 1

disorders or diseases that directly damage the renal glomeruli (but may exhibit normal function for a while)
- includes: nephrotic syndrome

Question 2

describe acute glomerulonephritis

Answer 2

• inflamed glomerulus w/ decreased capillary lumen
• onset of hematuria and proteinuria
• decreased GFR, anemia, increased BUN and creatinine
• RBC cast = suggestive
• related to recent beta hemolytic strep

Question 3

chronic glomerulonephritis

Answer 3

• lengthy glomerular inflammation leading to scarring and loss of nephron function
• minor decrease in renal function

Question 4

nephrotic syndrome

Answer 4

• different disease caused leading to injury and increased permeability of glomerular (increased pore size)
• massive proteinuria and hypoalbuminemia
• edema
• hyperlipidemia and lipiduria

Question 5

describe tubular diseases

Answer 5

tubular defects from progression of renal diseases
- decreased excretion or reabsorption of substances

Question 6

name the most clinically important tubular defect in tubular diseases

Answer 6

renal tubular acidosis - RTA
effects acid base balance

Question 7

list two kinds of RTA

Answer 7

• distal: unable to maintain pH balance between blood and tubular fluid
• proximal: decreased bicarb reabsorption = hyperchloremic acidosis

Question 8

describe upper urinary tract obstructions

Answer 8

• constricting lesion below distal collecting duct

Question 9

desibe lower urinary tract obstruction

Answer 9

• slow to void urine

Question 10

describe how obstructions in urinary tract may cause disease

Answer 10

• increase tubular pressure
• pressure leading to necrosis and chronic renal failure

Question 11

describe acute kidney injury

Answer 11

• form of renal failure
• sudden decline in renal function

Question 12

prerenal AKI

Answer 12

• defect in blood supply before it reaches kidney
• cardiovascular system failure -> hypovolemia

Question 13

intrinsic AKI

Answer 13

• kidney defect
• usually acute tubular necrosis
• vascular obstruction

Question 14

postrenal AKI

Answer 14

• defect post kidney in urinary tract
• lower urinary tract obstruction or rupture

Question 15

chronic kidney disease

Answer 15

• gradual decline in funciton over time
• graded based on albumin to creatinine ratio (ACR)

Question 16

describe A1 stageCKD

Answer 16

• albumin to creatinine ratio (ACR) <30 mg/g to 10-29 mg/g

Question 17

describe A2 stage of CKD

Answer 17

ACR 30-299 mg/g

Question 18

describe A3 stage of CKD

Answer 18

ACR >300 mg/g

Question 19

what GFR indicates renal failure

Answer 19

<15 mL/min

Question 20

list therapy options for acute kidney injury

Answer 20

• hemodialysis: synthetic membrane outside the body
• peritoneal dialysis: internal membrane
• hemofiltration: intensive care