Term
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Definition
- Fluid and electrolyte balance
- Blood filtration
- Acid-base balance
- Blood pressure regulation
- Erythropoietin production
- Vitamin D production |
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Term
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Definition
Functional unit of kidney
- Arteriole brings in unfiltered blood
- Glomerulus (ball of capillaries): filters blood, retains proteins and RBCs
- Distal tubule carres away filtered waste into the urine
- Venule returns filter blood to the body |
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Term
|
Definition
BUN (10-20)
Creatinine (<1.5)
GFR (125)
URinalysis: specific gravity, protein, blood |
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Term
|
Definition
| Decrease in the glomerular filtration rate so that the kidneys can no longer effectively filter water and waste from the blood |
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Term
|
Definition
- Acute renal failure (ARF): sudden onset, reversible with supportive care
- Chronic (CRF): gradual onset over months to years
- End stage renal disease |
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Term
|
Definition
- Usually doesn't go on over 3 months
- Half of the nephrons are destroyed |
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Term
| RIFLE criteria for renal failure |
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Definition
Risk: >25% GFR
Injury: GFR >50%
Failure: >75%
Loss: irreversible AKI or persistant AKI >4 wks
ESRD: ESRD >3 months |
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Term
| Acute kidney injury causes |
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Definition
Can be community acquired or secondary
- Due to hypovolemia
- Frequently part of multi organ failure |
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Term
|
Definition
- Age
- Diabetes
- Severe illness
- Atherosclerotic disease
- Dehydration |
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Term
|
Definition
Prerenal
Intrarenal
Postrenal |
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Term
|
Definition
- Most common type of AKI
- Hypoperfusion, results conditions that interrupt the renal blood supply, thereby reducing renal perfusion
- Nephrons remain structurally intact
- Causes: hypovolemia, shock, hemorrhage, diuretic therapy, sepsis |
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Term
|
Definition
- Results from obstruction of urine flow
- Least common cause of AKI
- Reversible with removal of obstruction unless its been present long enough to damage the kidney
- Causes: BPH, tumors, kidney stones, neurogenic bladder |
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Term
|
Definition
Direct injury to kidneys with structural and functional damage to nephrons
- Causes: ischemia, inflammation, infection, toxins, meds, IV contrast, rhabdomylosis |
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Term
|
Definition
- Oliguria
- Proteinuria
- Fluid retention
- Increased serum potassium
- Increased creatinine
- Decreased serum bicarb |
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Term
|
Definition
- Varies according to cause: treat precipitating condition
- Rehydration with IVF
- Monitor fluid status closely (strict I and Os)
- Monitor labs: BUN, creatinine, K+
- Treat hyperkalemia
- Oxygen
- Meds: diuretics
- Dialysis
(Metformin increases risk of kidney function) |
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Term
|
Definition
If you don't treat acute renal failure then go into chronic renal failure
- Progressive decline in kidney function that correlates with loss of nephrons
- Symptoms occur when less than 20-25% of nephrons remain (until then remaining nephrons hypertrophy to compensate) |
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Term
|
Definition
Diabetes
Hypertension
Unsuccessfully treated ARF
Glomerulonephritis
Autoimmune disorders
Congenital defects |
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Term
|
Definition
Malaise
Fatigue
Pruritis
Headaches
Weight loss
Anorexia and nausea
Edema
Hypertension
Polyuria |
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Term
|
Definition
Oliguria/anuria
CNS symptoms: drowsiness, confusion
Numbness in hands and feet
Easy bruising or bleeding
Excessive thirst
Breath orod of urine
Uremic frost
N/V, constipation/diarrhea
Stomatitis, gastritis |
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Term
|
Definition
Decompensated HF, pulmonary edema
Metabolic acidosis
Pericarditis (fluid around heart)
Pleural effusion
Arrhythmias
Anemia
Malnutrition |
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Term
|
Definition
- Goals: delay progression to ESRD, prevent complications, plan for long-term renal replacement therapy in a timely manner
- Hemodialysis
- Peritoneal dialysis
- Kidney transplant |
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Term
|
Definition
- Fluid restriction
- Diet restriction: low protein, low potassium, low sodium |
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Term
|
Definition
Antihypertensives
Diuretics
Meds to manage electrolytes
Erythropoietin |
|
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Term
|
Definition
- Dietary restrictions: low protein, low K, Na, phosphorous
- Fluid restrictions: replace urinary output plus 500ml
- Avoid OTC meds: NSAIDs, antacids and laxatives that contain magnesium |
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