Test 2: Kidneys Flashcards
Kidney Function
1) Filter Waste
2) Maintain F/E Balance
3) Maintain acid/baase balance
AKI Classifications
CR Increase by 0.3 w/in 48hrs
CR Increase 1.5x baseline in 7 days
Urine Vol < .5ml/kg in 6hrs
How does MODS occur?
Kidneys try to compensate but are unsuccessful, so liver kicks into help but then liver is unsuccessful, then MODS Occurs
Signs of voume depletion
Low UOP
Decrease SV
Decrease PP
OH
Thirst
Increase blood osmolarity
fluids needed to prevent damage*
Pre-Renal Failure
Before Kidneys
Decrease BF/Volume/Perfusion to kidneys which impairs perfusion to kidneys
Common Cause:
- Cardiac disease - MI, HTN, CHF
- Vasodilation
- Hemorhage/hypovolemia
- Burns
- GI Losses (vomiting/diarrhea)
- Shock
- Sepsis
Intrarenal Failure
Damage in kidneys - directly affects renal cortex/medulla
Prolonged Ischemia
Pathophysiology
Tissue/cell damage caused by inflammatory proteins produced by activated immunity and nephrotoxins
Common Causes:
Allergic disorders
Embolism
Thrombosis
Nephrotoxic Agent - nsaid, antibx, chemo, contrast dye
Intervention: Fluids to Increase BF and decrease casts
Nephrotoxic Syndrome
Genetic, autoimmune
Set of symptoms due to damage to glomerulus releasing massive amount of protein
Loss of > 3g/day
Mostly albumin lost which regulates oncotic pressure
S/Sx:
Na (decrease), fluid shift, edema, decrease UO
Albumin decrease
Protein decrease - hypoalbuminemia (>3g/day in urine)
Hyperlipidemia (energy)
Renal vein thrombosis
Orbital Edema - dialysis/CCRT needed
Thromboembolism
Infection
Coagulability
Interventions
1) Immunosupressors
2) Normal Saline
3) Albumin
4) GFR Normal - increase P, decrease GFR
5) Statin
6) Heparin - PTT, PT, INR
7) Culture for Antibx
Hypoalbuminemia: S/Sx, Risks
S/Sx
Puts us at risk for:
1) hyperlipidemia - increase cholesterol, triglyceride from liver
2) Fluid shift - edema
3) Thrombosis - albumin prevents clot formation
4) Infection - immunoglobulins fight infection
