Week 8b: Renal Disorders

Question 1

glomerular filtration rate

Answer 1

the flow rate of filtered fluid through the kidney

Question 2

creatinine clearance rate

Answer 2

volume of blood plasma that is cleared of creatinine per unit time

Question 3

what is one method of determining the GFR from the creatinine?

Answer 3

a 24 hour urine collection

Question 4

what are the causes of urinary tract obstruction?

Answer 4

• developmental defects
• calculi
• pregnancy
• BPH
• scar tissue resulting from inflammation and infection
• tumours
• neurological disorders such as spinal cord injury

Question 5

role of states of urine in urinary obstruction

Answer 5

predisposes to infection and stone formation

Question 6

urinary obstruction can result in the development of?

Answer 6

back pressure, which interferes with renal blood flow and destroys kidney tissue

Question 7

what are the common symptoms of urinary obstruction?

Answer 7

• pain
• signs and symptoms of UTI
• manifestations of renal dysfunction

Question 8

what are the requirements for kidney stone formation?

Answer 8

• a nidus to form

- a urinary environment that supports continued crystallization of stone components

Question 9

what are some preventative treatments for kidney stones?

Answer 9

• dietary restriction
• calcium salt supplementation for oxalate stones
• thiazide diuretics for calcium stones
• cellulose phosphate (Ca absorption)

Question 10

signs and symptoms of kidney stones

Answer 10

• renal colic pain that dull and aching, located in the back and radiates to the pelvis/scrotum and increases with high liquid intake
• nausea and vomiting

Question 11

characteristics of glomerulonephritis

Answer 11

• hematuria with red cell casts
• diminished GFR
• Azotemia (nitrogenous waste in the blood)
• oliguria
• hypertension

Question 12

what are the causes of glomerulonephritis?

Answer 12

diseases that provoke a proliferative inflammatory response of the endothelial mesangial or epithelial cells of the glomeruli

Question 13

nephritic syndromes

Answer 13

• begins with acute inflammation of the glomerulus causing glomerular damage
• sudden onset hematuria, variable degrees of proteinuria, diminished GFR, oliguria and signs of impaired renal function

Question 14

acute post infectious glomerulonephritis

Answer 14

occurs after infection group A beta hemolytic streptococci

Question 15

rapidly progressive glomerulonephritis

Answer 15

signs of severe glomerular injury with no specific cause

Question 16

nephrotic syndrome manifestations

Answer 16

massive proteinuria, lipiduria, hypoalbuminemia, generalized edema, hyperlipidemia

Question 17

hypertensive nephropathy

Answer 17

prolonged glomerular hypertension causes glomerular hyperfiltration, forcing proteins and cells through the glomerular membrane resulting in glomerular inflammation

Question 18

proximal and distal tubular acidosis results in?

Answer 18

metabolic acidosis with a normal anion gap

Question 19

acute pyelonephritis

Answer 19

infection of the upper urinary tract, specifically the renal parenchyma and the renal pelvis

Question 20

signs and symptoms of pyelonephritis

Answer 20

• abrupt onset of shaking chills
• moderate to high fever
• constant ache in the loin area of the back
• lower UTI symptoms
• malaise
• nausea and vomiting
• pain on palpation or percussion over the costovertebral angle

Question 21

chronic pyelonephritis

Answer 21

progressive process that results in scarring and deformation of the calyces and pelvis

Question 22

which drugs can cause crystal formation?

Answer 22

sulfanomides and vit C

Question 23

chronic analgesic nephritis

Answer 23

analgesic abuse results in interstitial nephritis with renal papillary necrosis

Question 24

prerenal

Answer 24

sudden or severe drop in blood pressure or interruption of blood flow to the kidneys from severe injury or illness

Question 25

intrarenal

Answer 25

direct damage to the kidneys by inflammation, toxins drugs, infection or reduced blood supply

Question 26

post renal

Answer 26

sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumour or injury

Question 27

signs and symptoms of acute renal failure

Answer 27

- high serum Cr, urea and BUN - decreased GFR - electrolyte imbalances - low specific gravity (non-concentrated urine) - presence of protein and blood cells in the urine - decreasing overall urine output - hypertension, edema

Question 28

Mild reduction of GFR

Answer 28

60 to 89 mL/min/1.73 m2

Question 29

Moderate reduction of GFR

Answer 29

30 to 59 mL/min/1.73 m2

Question 30

Severe reduction in GFR

Answer 30

15 to 29 mL/min/1.73 m2

Question 31

Kidney failure with a GFR

Answer 31

< 15 mL/min/1.73 m2

Question 32

Clinical manifestations of chronic renal failure

Answer 32

- Accumulation of nitrogenous wastes - Alterations in water, electrolyte and acid-base balance - Mineral and skeletal disorders - Anemia and coagulation disorders - Hypertension and alterations in cardiovascular function - Gastrointestinal disorders - Neurologic complications - Disorders of skin integrity - Immunologic disorders

Question 33

symptoms associated with uraemia

Answer 33

``` Fatigue/weakness N&V Pruritus, uremic frost Serositis Peripheral neuropathy Uremic encephalopathy: confusion, apathy ```

Question 34

stage 1

Answer 34

Kidney damage with normal renal function GFR >90 ml/min but with proteinuria (3 months or more

Question 35

stage 2

Answer 35

Kidney damage with mild loss of renal function GFR 60-89 ml/min with proteinuria (3 months or more)

Question 36

stage 3

Answer 36

Mild-to-severe loss of renal function GFR 30-59 mL/min

Question 37

stage 4

Answer 37

Severe loss renal function GFR 15-29 mL/min

Question 38

stage 5

Answer 38

End stage renal disease GRF less 15 mL/min

Question 39

normal GFR

Answer 39

>90ml/min

Question 40

what GFR indicates kidney failure

Answer 40

less than 15

Question 41

what GFR indicates kidney disease?

Answer 41

15 to 60

Question 42

what GFR indicates normal kidney function

Answer 42

60-120