Topic 5 Renal System Disorders Flashcards
Define: Haematuria
Red Blood Cells in the urine.
Define: uraemia
Urine in the blood.
Define: oligouria
Reduced urine output.
Define: anuria
No urine output.
Define: proteinuria
excessive protein levels.
Define: bacteriuria
bacteria in the urine.
Define: hyperuricosuria
excessive uric acid in the urine.
Define: pyuria
Pus or white blood cells in the urine.
Define: azotemia
Increased Blood Creatinine - i.e. retention of excessive amounts of nitrogenous compounds in the blood. (creatinine = a substance formed from the metabolism of creatine).
How does BUN change as a result of renal failure?
BUN (blood urea nitrogen) levels = INCREASES / builds up.
How does serum creatinine change as a result of renal failure?
Serum creatinine levels = INCREASE.
How does GFR (Glomerular Filtration Rate) change as a result of renal failure?
GFR = DECREASES to 15mL/min/
What is colicky pain?
Wavelike pain in the abdomen OR Dysuria = painful urination.
Define: BUN
Blood Urea Nitrogen, i.e. a measure of the amount of urea in the blood. (Urea forms in the liver as the end product of protein metabolism - circulates in the blood - excreted through the kidney in urine).
Dysfunction of the Renal System =
3 main areas:
- Obstruction
- Infection & Inflammation
- Destruction of Renal Tissue
Disorders of Glomerular Function: 2 categories
- Nephritic Syndromes = inflammatory response to lesions or damage to glomerular cells.
- Nephrotic syndromes: characterised by large amounts of protein moving into the urine = hypoalbuminemia (lack of albumin in blood) & hyperlipidemia (increases lipids in the blood).
Nephritic Patho-Pyshiological manifestations:
Characterised by:
- sudden onset of hamaturia (RBC’s in blood) & proteinuria.
- deminished GFR
- oliguria (reduced urine output)
- azotemia (increased nitrogenous waste in blood)
- salt & water retension = edema / hypertension.
Nephrotic Patho-Pyshiological manifestations:
Characterised by:
- massive proteinuria
- lipiduria (lipids in the urine)
- hypoalbuminemia (low levels of albumin in the blood)
- hyperlipidemia (an excess of lipids in the blood)
Define: Renal Failure
Kidneys fail to:
- remove metabolic waste from blood
- regulate the fluid, electrolyte & pH balance of the extracellular fluid.
What are the types of Renal Failure?
Acute: abrupt in onset, often reversible. Casues are categorised into 3 groups: Prerenal, Postrenal, Intrinsic.
What the 3 types of Acute Renal Failure?
a. Pre-renal: caused by decreased bloody supply to kidney due to: shock, dehydration, vasoconstriction.
b. Post-renal: caused when urine flow is blocked (bilateral ureteral obstruction i.e. stones, enlarged prostate OR bladder outlet obstruction).
c. Intrinsic Acute Renal Failure: is caused when kidney function is decreased due to ischemia, toxins, intratubular obstruction.
Define: Creatinine
creatinine = a substance formed from the metabolism of creatine (i.e. muscle metabolism).
Define: azotemia
= accumulation of nitrogenous wastes in the blood.
Define: hydro-nephrosis
refers to the urine-filled dilation of the renal pelvis & calices associated w’ progressive atrophy of the kidney due to obstruction of urine outflow.
Define: albuminuria
High levels of albumin in the urine.
Define: albumin
Albumin = a water soluble plasma protein. contributes to plasma osmotic pressure & maintenance of blood volume.
Nephritic Condition =
= inflammatory response to damage to glomerulus.
Nephrotic Condition =
= where the glomerular capillary membrane integrity is affected.
Describe: peritoneal dialysis
= the peritoneal cavity serves as the dialysing membrane for the dialysis process.
- a catheter is surgically implanted in to the peritoneum.
# 3 Phases:
1. Inflow: dialysate is introduced
2. Equilibration (swelling): (diffusion, osmosis, ultrafiltration)
- electrolytes pass through to bloodstream via vascular peritoneum
- waste products pass from blood vessels into dialysate.
3. Draining:
Describe: Haemo (urinary) dialysis
= a procedure in which impurities or wastes are removed from the blood by a machine (i.e. an artificial kidney) using the principles of diffusion, osmosis, ultrafiltration.
- the dialyser: a hollow cylinder
- a blood delivery system (pump)
- a dialysis fluid delivery system
Define: UTI’s
Urinary Tract Infection - an infection of one or more structures of the urinary system.
- Most UTI’s are caused by gram-negative bacteria (E. Coli - 80-85%, Staphloccocus)
What do Lower UTI’s cause:
- cystitis: inflammation of the bladder
- urethritis: inflammation of the urethra
What do Upper UTI’s cause:
- pylonephritis: inflammation of the kidneys
Define: Chronic Renal Failure (CRF)?
= when fewer nephrons are functioning = therefor; hyperfusion & hypertrophy occur.
CRF: ‘Diminished Renal Reserve’
= nephrones are working as hard as they can.
CRF: ‘Renal Insufficiency’
= nephrons can no longer regulate urine denisty.
CRF: ‘Renal Failure’
= nephrons can no longer keep blood composition normal.
CRF: ESRD
= End Stage Renal Failure
What is ATN?
Acute Tubular Necrosis.
- characterised by the destruction of tubular epithialial cells leading to acute suppression of renal function.
What causes ATN?
acute tubular damage due to:
- ischemia
- drug toxicity
- toxins from infections
- obstruction
- sepsis
What are ATN’s manifestations?
- decreased consciousness
- delirium or confusion
- drowsy, lethargic, hard to arouse
- decreased urine output or no urine output
Define: Glomerulonephritis
= occurs when the glomeruli (tiny filters on the kidney) become inflamed.
Kidney obstruction is usually caused by:
renal calculi (stones)
Define: hypovolaemia
= low blood volume
What do the kidneys do during Hypovolaemia?
- secrete ‘renin’; which stimulates the production of angiotensin, which causes blood vessels to constrict (vasoconstrict), resulting in increased BP.
What does the production of Angiotensin stimulate?
= the secretion of ‘Aldosterone’ (vasopressin) from the adrenal cortex which causes the kidney tubules to increase the reabsorption of sodium & water into the blood. This increases the volume of fluid in the body - which increases BP.
