Term
| give the three classes (+examples) of chronic renal failure. |
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Definition
Pre-renal
1.renal artey disease eg stenosis = decreased glomerular filtration rate and hypertension
2. Severe HF = decreased kideny perfusion
Renal
1 chronic glomerularnephritis
2 diabetic nephropathy
3 toxic eg drugs cyclosporine and gold
Post renal
1 obstuctive uropathy |
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Term
| What is the mechanism of disease in glomerulonephritis? |
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Definition
= inflammatory condition involving glomerular filtration membrane. Associated with loss of charge on membrane.
Excess glomerular filtration and protein leakage, but DECREASED glomerular filtration rate. |
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Term
| What is the pathological mechanism of diabetic nephropathy? |
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Definition
BM thickening
Expansion of mesangium (increased glomerular kPa)
Hyaline thickening of afferent/efferent arterioles = stenosis
glomerular scarring |
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Term
| Define chronic renal failure. |
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Definition
| Progressive decline in renal function where GFR decreases until can no longer sustain life. |
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Term
| What are the consequences of chronic renal failure? |
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Definition
Decreased EPO = normocytic normochromic anaemia
Volume overload = HR/Hypertension/oedema
Uraemic syndrome = N/V/jaundice/puritus/pericarditis/drowsiness
Bone disease - dec alpha-1-hydroxylase = decreaded formation of active Vit D = dec Calcium absorption from GIT (as decreased calbindin) = 2ry hyperparathyroidism
Impaired ecretion of water/Acid/K |
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Term
| What are the 2 principles of management in acute renal failure? |
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Definition
1. renoprotection
2. Correct complications |
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Term
| What constitutes "renoprotection"? |
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Definition
= Correct BP and decrease BP
ACE Inhibitior
Ang II recep blocker
Diuretics |
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Term
| How do you manage the aditional complications of renal failure? |
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Definition
EPO injections
Replace viotamin D alfacalcidol
Oral CaCO3 = calcichew
low potassium diet |
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Term
| What are the 2 different types of dialysis |
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Definition
Haemodialysis
Peritoneal dialysis |
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Term
| What 4 problems are associated with haemodialysis? |
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Definition
Hypotension
allergy
clots
Infection |
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