Renal medicine Flashcards
average GFR?
125ml/min
how many litres of filtrate and urine a day?
180l filtrate
1.5l urine
how do you measure renal function?
serum creatinine via blood test
what is GFR?
glomerular filtration rate = sum of filtration rates of all functioning nephrons
how is creatine filtered across glomerulus??
freely
how does creatine plasma conc effect GFR?
increased creatine = decreased GFR
how many stages of chronic kidney disease?
5
what is GFR in stage 5 CKD?
<15ml/min
how does muscle mass affect GFR?
muscly people make more creatine = higher GFR
most common cause of CKD?
diabetes
what stage CKD do symptoms show?
stage 4
why does CKD caused hypertension?
solutes retained
why does CKD cause anaemia?
reduced erythroprotein production
why are phosphate binders used in CKD?
to reduce phosphate serum levels
what anti-hypertensive drugs are usually taken in CKD?
duiretics
why may someone with CKD bleed for longer?
uraemia = urea level build up, these stop platelets working
why may CKD cause cardiac instability?
metabolic acidosis - hyperkalaeima + hypocalcaeimia
how are haemodialysis patients anti coagulated?
with heparin
2 types of dialysis?
extra-corporeal
peritoneal dialysis
are peritoneal dialysis patients anti coagulated?
no
when is the ideal time to see a dialysis patient?
day after dialysis - dialysis peaked but heparin worn off
what is nephrotic syndrome? what can it lead to?
too much protein excreted in urine
lead to oedema
definition of chronic kidney injury?
low GFR for more than 3 months
occurs after progressive kidney damage
why do patients suffering from nephrotic syndrome have increased risk of infection?
probably taking long term steroid
electrolyte imbalance
what is renal osteodystrophy?
wasting away of bone due to kidney disease
result from increase in plasma phosphate levels
suppression of plasma calcium
elevated PTH
thing to be aware of when examining patient with CKD?
oedema steroid faces pulmonary/cardiac effusions osteodystrophy - bone pain infection increase gingival hyperplasia - ciclosproin beware of skin cancers
common oral side effect of dialysis?
sialosis - infective swelling of salivary gland
oral manifestations of CKD in children?
decreased growth, delayed tooth eruption, enamel hypoplasia
why must CKD patients not swallow blood?
heavy protein load
which drugs should be avoided in kidney disease?
NSAIDs
tetracyclines except doxycycline
gentamycin
what happens in acute renal failure?
potassium levels rise - must be lowered by either calcium resonium paste or glucose + insulin infusions
