Uro - CKD + Renal Failure Flashcards
What are the homeostatic functions of the kidney?
→ electrolyte balance
→ acid-base balance
→ volume homeostasis
What are the excretory functions of the kidneys?
→ nitrogenous waste → hormones → peptides → middle sized molecules → salt + water
What are the endocrine functions of the kidney?
→ erythropoietin
→ 1 alpha-hydroxylate vitamin D
What are the glucose metabolic functions of the kidneys?
→ gluconeogenesis
→ insulin clearance
How does kidney failure affect homeostatic function?
→ increase in K+ → decrease in bicarbonate → decrease in pH → increase in phosphate → salt + water imbalance
How does kidney failure affect excretory function?
build-up of waste products
→ increased urea
→ increased creatinine
→ decreased insulin requirement as insulin is no longer being cleared so it circulates in blood
How does kidney failure affect endocrine function?
→ hypocalcemia due to lack of 1 alpha-hydroxylase
→ lack of erythropoietin = anaemia
→ hyperparathyroidism due to compensation for calcium
What is a general important risk from kidney failure?
cardiovascular risk
What factors can influence clinical presentation?
cause of renal failure
rate of deterioration
→ chronic slow deterioration can present much slower and less obviously as body adapts to kidney’s changes
→ acute kidney failure or change presents quicker
*What is abnormal about this urogram?
contrast only showing up on right side, only showing shadow of her right kidney
What is the blood volume + blood pressure of someone with renal failure like?
hypovolemia + low BP
may also present with decreased capillary refill time + not visible JVP
Why might someone with renal failure be tachypneic?
→ due to metabolic acidosis as a result of renal failure
→ compensatory mechanism of respiratory alkalosis
→ causes them to breathe faster
Does renal failure cause urea and creatinine to increase or decrease?
increase
Does renal failure cause sodium to increase or decrease?
difficult to say, depends on hydration
Does renal failure cause potassium to increase or decrease?
increase
Does renal failure cause haemoglobin to increase or decrease?
decrease
What happens in blood pH in renal failure?
Goes down due to acidic.
What would happen to pCO2 if the patient is tachypneoic?
Goes down due tonthe resp compensation
What would happen to pO2 is patient is tachypneoic?
Goes up
What are the main differences in presentation between chronic and acute renal failure?
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What are the main differences between investigaton results between chronic and acute renal failure?
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What is the effect of kindey failure usually on salt + water balance?
Reduces secretion of salt and water, leading to :
Hypertension
Oedema
Pulmonary oedema