Renal Patho Flashcards by Emily Byford

how many nephrons does the kidney have?

1 million

How well did you know this?

Not at all

Perfectly

what are some functions of the kidney?

control solutes/fluids
BP control
acid/base balance
drug metabolism & excretion
metabolic waste excretion
endocrine functions

How well did you know this?

Not at all

Perfectly

how much filtrate is produced in the bowmans capsule?

100%

How well did you know this?

Not at all

Perfectly

how much filtrate is reabsorbed in the PT and what kind?

active and passive reabsorption
80%

How well did you know this?

Not at all

Perfectly

how much is reabsorbed and what is in the loop of henle?

6%
H20 and salt conservation

How well did you know this?

Not at all

Perfectly

how much is reabsorbed in the DT and what type?

variable reabsorption, active secretion
9%

How well did you know this?

Not at all

Perfectly

how much is reabsorbed in the CT and what?

4%
variable salt and H@0 reabsorption

How well did you know this?

Not at all

Perfectly

how much volume does the urine have?

1 % total filtrate volume

How well did you know this?

Not at all

Perfectly

what is the water permeability of the PCT and how much Na/K/Ca is reabsorbed?

very high
65%

How well did you know this?

Not at all

Perfectly

what is the function of the straight segments of the PT and what is the water permeability?

very high
secretion and reabsorption of organic acids and bases (uric acid)

How well did you know this?

Not at all

Perfectly

what is the water absorption for the thin loop of henle?

high

How well did you know this?

Not at all

Perfectly

what is the water permeability of the thick loop of henle and the amount of Na/K/Cl absorbed?

very low
15-25%

How well did you know this?

Not at all

Perfectly

what is the water permeability of the DCT and the percent of Na/K/Cl reabsorbed?

very low
4-8%

How well did you know this?

Not at all

Perfectly

what is the water permeability of the CCT and MCT? what is the MCT under control of?

variable for both
vasopressin

How well did you know this?

Not at all

Perfectly

what are some measures of function?

SCr
BUN
CrCl
GFR

How well did you know this?

Not at all

Perfectly

what are the markers of damage?

urinary abnormalities
- imaging abnormalities

How well did you know this?

Not at all

Perfectly

what is the compensatory response to renal injury?

Renal Injury –> dec. nephrons –> compensatory inc. in size/ function of remaining nephrons –> glom/tub lesions –> large loss of nehrons –> decrease in GFR –> azotemia –> uremic syndrome –> death

what accounts for the MOST renal failure cases in the US and what percent?

HTN and diabetes
60%

what is the impact of AKI/AKF in hospitals and general?

300,000 die from AKI
LOS inc. to 3.5 days
high cost
high death rate

what is the patho and lab values of AKI?

inc. in SCr > or equal to 0.3 mg/dL within 48h
OR
inc. in SCr >50% prior to 7 days
OR
reduced urine output < 0.5 mL/kg/h for 6 h

what are the 3 types of AKI?

prerenal
- intrarenal
- postrenal

what are the major causes of intrinsic AKI?

sepsis
ischemia
- nephrotoxins

what are the most important parts of CKD in nephropathies?

inc. glomerular cap pressure
proteinuria
glomerulosclerosis

what are the key abnormalities in CKD-MBD?

impaired phosphate excretion
decreased production of 1.25 D3

what is uremia?

accumulation of organic waste products

what is nephritic syndrome?

1. inflammation of disruption of glomerulus 2. causes hematuria

what is nephrotic syndrome?

- podocyte damage leading to glomerular disruption - massive proteinuria

what does nephrotic cause that nephritic doesn't?

edema proteinuria low serum albumin

what does nephritic cause that nephrotic doesn't?

hematuria - RBC clasts present

what is glomerulonephritis and its secondary causes?

1. has acute and chronic forms - secondary cause: infections. drugs. and autoimmune disorders

what is the pathogenisis of glomerular diseases?

1. antibody associated injury - cell mediated immune 3. other mechanisms of injury

what is pyelonephritis?

- can cause acute and chronic forms - presents flank pain with painful urination - white cells in urine - may lead to sepsis

what is the pathway of a UTI?

1. colonization --> uroepithelium penetration --> ascension --> pyelonephritis --> AKI

what is interstitial nephritis and causes?

- undetected until causes significant decrease in renal function - CAUSES: -- drugs (70-75%), mostly antibiotics -- infection (4-10%)

what antibiotics are associated with interstitial nephritis?

penicillins

what is responsible for APKD in adults? what mutation?

- most common form of cystic renal disease (DOMINANT) - PKD1 inherited or PKD2 gene in renal tubular cells

what cystic kidney disease is in children that is rare and from what mutation?

- APKD (recessive) - from mutation PKHD-1 fibrocystin

what is nephrolithiasis and prevalence?

- arises from supersaturation of solutes (calcium) - aka kidney stones - prevalence is 10% M and 5% W

what are some symptoms of kidney stones?

- hematuria - sharp, sudden; severe pain

what is the frequency of different causes of nephrolithiasis for calcium, uric acid, and magnesium ammonium phosphate?

- calcium (70-80%) - uric acid (10-15%) - magnesium ammonium phosphate (10-15%)

what is the treatment for nephrolithiasis and prevention?

1. primary Tx: --> analgesics --> hydration --> removal 2. prevention --> diet (hydration, eliminate Ca supps), --> diuretics

what is the contrast-associated nephropathy conclusion?

1. recent work suggests frequency may be over estimated and most methods to reduce incidence have proven ineffective