Week 3 - Study Guide Flashcards
what is CKD
- the progressive, irreversible loss of kidney function
- GFR < 60 for 3 months or longer
what stage of CKD is considered end-stage renal disease? what do most patients in this stage require?
- stage 5
- require either dialysis or transplant
define uremia; at what point does it usually occur?
- constellation of signs & symptoms resulting from buildup of waste products & excess fluid associated w kidney failure
- often occurs when GFR is 10 or less
what 3 main functions are lost during CKD? what does this cause
- excretory
- regulatory
- endocrine
= causes symptoms in every body system
define oliguria
- diminished urine volume
define anuria
- absence of urine production
define azotemia
- the accumulation of metabolic wastes that are typically excreted by the kidneys in the blood
describe the effect of CKD on carb metabolism; what does this cause
- insulin resistance occurs resulting in impaired glucose use & defective carb metabolism
- this causes hyperglycemia & hyperinsulinemia
- hyperinsulinemia then causes elevated triglycerides & dyslipidemia
describe the clinical manifestations of CKD on the urinary system
- in the early stages, we get polyuria & nocturia bc of increased GFR due to increased wokrload on the remaining nephrons
- eventually get oliguria & anuria as loss of renal function progresses
define proteinuria
- protein in the urine
what is urine osmolality? what does a large value indicate? small?
- a measure of urine conc
- high value = v concentrated
- small = not v concentrated/diluted
what is a pleural effusion
- fluid in the pleural cavity
define pruitis
- itching
define pericarditis
- inflamamtion of the pericardium (membrane around the heart)
define thrombocytopenia
- low plt levels
define stomatitis
- inflammation of the mouth & lips
define paresthesias
- abnormal sensation of the skin
- tingling, prickling feeling
define paresthesias
- abnormal sensation of the skin
- tingling, prickling feeling
define uremic frost
- deposits of tiny yellow-white urea crystals on the skin
define renal osteodystrophy
- deformities of the bone that occur due to abnormal blood levels of calcium & phosphate, leading to demineralization
define asterixis
- tremor of the hand when the wrist is extended
- “hand flapping”
define hyperparathyroidism
- excessive parathyroid hormone due to overactivity of the parathyroid gland
define ecchymosis
- bruise
define encephalopathy
- damage or disease that effects the brain
what is acute tubular necrosis
- the most common intrarenal cause of AKI
- necrotic death of tubule epithelia cells
define peritoneal dialysis; how does it work
- dialysis that involves the use of the peritoneum as a natural semipermeable membrane (filter) to remove wastes and excesss fluid from the body
- fluid is infused into the peritoneum, excess fluid & wastes cross the membrane into the fluid, which is then drained out
define hemodialysis
- dialysis that uses a machine with an artificial semipermeable membrane to filter wastes out of your blood
what is an arteriovenous fistula
- hemodialysis that requires the connection of an artery & vein
what is chemotherapy
- pharmacologic treatment for cancer
what is dialysis
- movement of fluid & molecules acorss semipermeable membrane from one compartment to another
- clinically, it is a technique in which substances move from the blood thru a semipermeable membrane (dialyzer) and into a dialysis solution (dialysate)
what are the 2 types of dialysis
- peritoneal dialysis
- hemodialysis
when is dialysis therapy initiated
- when CKD progresses to the point that the pt’s symptoms, fluid volume status, or both can not be managed without dialysis
- usually when GFR < 15
what are the pros to peritoneal dialysis (7)
- less complicated than hemo
- portable system
- fewer diet restriction
- short training time
- usable in pt’s with vascular access problems
- less cardio stress
- preferred for the diabetic pt
list the cons to peritoneal dialysis (8)
- protein loss into dialysate
- exit site & tunnel infection
- self-image problems w catheter placement
- hyperglycemia
- surgery required for catheter
- catheter can migrate
- contraindication in patients with multiple abdom surgeries, unrepaired hernia, trauma
- bacterial or chemic peritonitis
list the pros to hemodialysis (7)
- rapid fluid removal
- rapid removal of urea & creatinine
- effective K+ removal
- less protein loss
- lowering of serum triglycerides
- home dialysis possible
- temp access can be placed at bedside
list the cons to hemodialysis
- vascular access problems
- dietary & fluid resitrctions
- heparinization may be required
- hypotension during dialysis
- added blood loss contributes to anemia
- surgery for perm access placement
- self-image problems w perm access
how often do patients receive dialysis?
- minimum 3 days/week
- 3-5 hrs long
list 2 other options for a person w end-stage renal disease
- continuous renal replacement therapy
- kidney transplant
what is continuous renal replacement theraoy
-
why do some people w ESRD get kidney transplants? (3)
- when normal kidney function is restored, the pathophysiological changes associated w renal failrue are reversed
- eliminates dependence on dialysis & diety and fluid restrictions
- less expensive than dialsysis after the first year
