Week 7 - Kidney Disease Flashcards
What is the function of the kidney
Blood volume and fluid osmolality
Electrolyte balance
Acid-base balance
Eliminate Metabolic products and foreign substances
Produce and secrete hormones
- renin, activates renin-angiotensin-aldosterone system involved in reg of BP and maint of sodium and potassium balance
- calcitriol, active Vit D3
- erythropoietin (EPO) stim the bone marrow to produce RBC
Millions of nephrons are in the
Kidneys
What 3 functions happen in the nephron
Filtration
Reabsorption
Secretion
Where does filtration happen in the kidney
capillaries surrounded by bowman’s capsule
Where does reabsorption happen in the kidney
Proximal convoluted tubule
Loop of henle
Distal tubule
Collecting duct
Where does secretion happen in the kidney
Distal convoluted tubule
Collecting duct
A type of chronic kidney disease where the kidney stops working well enough for the patient to live without dialysis or kidney transplant
End-stage renal disease (ESRD)
End-stage renal disease (ESRD) is permanent or not permanent
Permanent
Causes of End-stage renal disease (ESRD)
*Diabetes, HTN - MC Genetic defects Reaction to medicine Physical injury/trauma to kidneys Chronic renal failure
Types of chronic kidney disease (3)
Chronic renal insufficiency
Chronic renal failure
ESRD
Impaired kidney function, but minimal effects to the body
Chronic renal insufficiency
Impaired kidney function, some effects to the body including
- waste products accumulate
- increased anemia
- bone disease
- acidosis
- salt and fluid retention
Chronic renal failure
Why bone disease in chronic renal failure?
Increased serum phosphorus Increased PTH secretion Decreased vit D Decreased Ca absorption and deposition Decreased calcitriol production
how does diabetes contribute to chronic kidney disease (CKD)?
Cells in kidneys close to blood vessels thicken as a result of glycosylation of matrix protein
Glomeruli thicken as a result of protein glycosylation
Glomeruli sclerosis due to protein glycosylation
Hyperglycemia activates cytokines, protein kinase C, CRP which contributes to renal and vascular problems
How does hypertension contribute to CKD
High BP physically damages vascular walls
Diagnostic test for ESRD
Blood pressure
Urine test
Glomerular filtration rate measures blood creatinine levels
A type of kidney disease in which nephrons (esp glomeruli) are inflamed/damaged
Glomerulonephritis
Sx of Glomerulonephritis
RBC in urine
Foamy urine
Edema
And more
Diagnostic tests for Glomerulonephritis
Urine test
Blood tests
Imaging tests
Kidney biopsy
A disorder that usually occurs when an infection in the digestive system produces toxic substances that destroy RBC and injure nephrons
Hemolytic-uremic syndrome (HUS)
Causes of Hemolytic-uremic syndrome (HUS)
E.coli
Shigella
Salmonella
Symptoms of Hemolytic-uremic syndrome (HUS)
Vomiting, diarrhea
Less frequent urination
RBC destruction = anemia
Diagnostic tests for Hemolytic-uremic syndrome (HUS)
Blood tests CBC Urine tests Kidney biopsy Stool culture might be positive for e.coli or other bacteria
A kidney disorder in which IgA antibiotics build up in the glomeruli
IgA nephropathy a.k.a. Berger’s disease
Causes of IgA nephropathy a.k.a. Berger’s disease
High levels of IgA
Sx of IgA nephropathy a.k.a. Berger’s disease
Maybe nothing for years
Blood in urging
Edema
Sx of ESRD
Diagnostic tests for IgA nephropathy a.k.a. Berger’s disease
Blood tests
Kidney biopsy
Urine test
A group of sx that include protein in the urine, low blood protein levels, high cholesterol levels, edema
Nephrotic syndrome
Causes of Nephrotic syndrome
Glomerulonephritis Cancer Diabetes, lupus, MM, amyloidosis Genetic disorders Immune disorders Infections Drugs
Sx of Nephrotic syndrome
Edema Foamy urine (high levels of protein)
Diagnostic tests for Nephrotic syndrome
Albumin blood test
Blood chem test
Blood test
Urinalysis
Formation of crystals in bladder and upper urinary system
Kidney stones
What is the composition of Kidney stones
Calcium
Uric acid
Struvite
Causes of Kidney stones
Genetic
Gender M>F
Metabolic disease
Sx of Kidney stones
Intermittent Radiating Pain Nausea Vomiting Abdominal dissension Chills and fever if infected
Diagnostic tests for Kidney stones
US
Cystoscopy
