Renal Lecture for Mordecai Flashcards
Normal Ionized Calcium Level
1.2-1.38 mmol/L
Ionized Calcium Levels are affected by what 2 things?
Albumin Levels
pH
Causes of Hypocalcemia
Decreased PTH secretion
Mg Deficiency
Low Vit. D
Renal Failure
Massive Blood Transfusion
Most common causes of Hypercalcemia
Hyper-Parathyroid (<11)
Cancer (>13)
S/S of Hypocalcemia
Paresthesias
Irritability
Siezures
Myocardial Depression
Post-Parathyroidectomy-hypocalcemia-induced laryngospasm (life threatening complication)
S/S of Hypercalcemia
Confusion, lethargy
Hypotonia/↓DTR
Abd pain
N/V
Short QT-I
*Chronic ↑Ca++→ Hypercalciuria & nephrolithiasis
Causes of Hypomagnesemia
Low Dietary Intake
Renal Wasting
Symptoms of Hypomagnesemia
Muscle Weakness or excitation
Seizures
Ventricular Dysrhythmias (Torsades)
Causes of Hypermagnesemia
(Generally due to over-treatment)
Pre-Eclampsia
Pheochromocytoma
Symptoms of Hypermagnesemia
4-5 mEq/L: Lethargy, N/V, Flushing
>6 mEq/L: HoTN, ↓DTR
>10 mEq/L: Paralysis, apnea, heart blocks, cardiac arrest
Treatment of Hypermagnesemia
Diuresis
IV Calcium
Dialysis
Where are the Kidneys Located?
Is the Right higher or lower to the Left?
Why?
Located Retroperitoneal between T12-L4
Right is slightly lower (Caudal) than the left
Placement is to accommodate the liver
How much CO do the kidneys receive?
20%
(1-1.25 L/min)
How much of the blood flow does the Cortex receive?
85-90%
Primary Functions of the Kidney
Regulate EC volume, osmolarity, composition
Regulate BP (intermediately & LT) *RAAS, ANP
Excrete toxins/metabolites
Maintain acid/base balance
Produce hormones (Renin, Erythropoietin, Calcitriol, Prostaglandins)
Blood glucose homeostasis
Which renal lab value is the best measure of renal function over time and is heavily influenced by hydration Status?
GFR (125-140 ml/min)
Which renal Lab Value is the most reliable measure of GFR?
Creatinine Clearance (110-140 ml/min)
What is the relationship between Serum Creatinine and GFR?
Inverse Relationship
Which renal lab value is best for identifying acute changes?
Serum Creatinine
This renal function lab has a norm of 10:1 and is a good measure of hydration status
BUN:Creatinine Ratio
Proteinuria level of > 750 mg/day could suggest what 2 issues?
Glomerular Injury
UTI
How many hospitalized/ICU patients does AKI affect?
20% Hospitalized
50% ICU Patients
What is Azotemia?
What is it a Hallmark sign of?
Buildup of nitrogenous products s/a urea & creatinine
Hallmark sign of AKI
