Week 8b: Renal Disorders Flashcards
glomerular filtration rate
the flow rate of filtered fluid through the kidney
creatinine clearance rate
volume of blood plasma that is cleared of creatinine per unit time
what is one method of determining the GFR from the creatinine?
a 24 hour urine collection
what are the causes of urinary tract obstruction?
- developmental defects
- calculi
- pregnancy
- BPH
- scar tissue resulting from inflammation and infection
- tumours
- neurological disorders such as spinal cord injury
role of states of urine in urinary obstruction
predisposes to infection and stone formation
urinary obstruction can result in the development of?
back pressure, which interferes with renal blood flow and destroys kidney tissue
what are the common symptoms of urinary obstruction?
- pain
- signs and symptoms of UTI
- manifestations of renal dysfunction
what are the requirements for kidney stone formation?
- a nidus to form
- a urinary environment that supports continued crystallization of stone components
what are some preventative treatments for kidney stones?
- dietary restriction
- calcium salt supplementation for oxalate stones
- thiazide diuretics for calcium stones
- cellulose phosphate (Ca absorption)
signs and symptoms of kidney stones
- 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
characteristics of glomerulonephritis
- hematuria with red cell casts
- diminished GFR
- Azotemia (nitrogenous waste in the blood)
- oliguria
- hypertension
what are the causes of glomerulonephritis?
diseases that provoke a proliferative inflammatory response of the endothelial mesangial or epithelial cells of the glomeruli
nephritic syndromes
- 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
acute post infectious glomerulonephritis
occurs after infection group A beta hemolytic streptococci
rapidly progressive glomerulonephritis
signs of severe glomerular injury with no specific cause
nephrotic syndrome manifestations
massive proteinuria, lipiduria, hypoalbuminemia, generalized edema, hyperlipidemia
hypertensive nephropathy
prolonged glomerular hypertension causes glomerular hyperfiltration, forcing proteins and cells through the glomerular membrane resulting in glomerular inflammation
proximal and distal tubular acidosis results in?
metabolic acidosis with a normal anion gap
acute pyelonephritis
infection of the upper urinary tract, specifically the renal parenchyma and the renal pelvis
signs and symptoms of pyelonephritis
- 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
chronic pyelonephritis
progressive process that results in scarring and deformation of the calyces and pelvis
which drugs can cause crystal formation?
sulfanomides and vit C
chronic analgesic nephritis
analgesic abuse results in interstitial nephritis with renal papillary necrosis
prerenal
sudden or severe drop in blood pressure or interruption of blood flow to the kidneys from severe injury or illness
intrarenal
direct damage to the kidneys by inflammation, toxins drugs, infection or reduced blood supply
post renal
sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumour or injury
signs and symptoms of acute renal failure
- 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
Mild reduction of GFR
60 to 89 mL/min/1.73 m2
Moderate reduction of GFR
30 to 59 mL/min/1.73 m2
Severe reduction in GFR
15 to 29 mL/min/1.73 m2
Kidney failure with a GFR
< 15 mL/min/1.73 m2
Clinical manifestations of chronic renal failure
- 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
symptoms associated with uraemia
Fatigue/weakness N&V Pruritus, uremic frost Serositis Peripheral neuropathy Uremic encephalopathy: confusion, apathy
stage 1
Kidney damage with normal renal function GFR >90 ml/min but with proteinuria (3 months or more
stage 2
Kidney damage with mild loss of renal function GFR 60-89 ml/min with proteinuria (3 months or more)
stage 3
Mild-to-severe loss of renal function GFR 30-59 mL/min
stage 4
Severe loss renal function GFR 15-29 mL/min
stage 5
End stage renal disease GRF less 15 mL/min
normal GFR
> 90ml/min
what GFR indicates kidney failure
less than 15
what GFR indicates kidney disease?
15 to 60
what GFR indicates normal kidney function
60-120
