Term
What is the most common cause of kidney failure? |
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Definition
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Term
What is a second most common cause of kidney failure? |
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Definition
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Term
How much kindey fxn can be lost before sx develop? |
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Definition
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Term
When is pain felt during kidney failure/dx? |
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Definition
Only if stretching of renal fascia or muscular contraction of ureters |
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Term
What % of pt's have a GFR of 50-60 mL/min that are diagnosed by primary care physician? |
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Definition
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Term
What is the threshold for kindey dx to be considered chronic? |
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Definition
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Term
What are the three general locations for kidney failure to act? |
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Definition
pre-renal - burns, blood loss, other systemic problem leads to kidney dysfunction
intrinsic - the kidney itself is the cause, perhaps with the medulla or tubules, etc. Even with normal bloodflow, still going to fail
post-renal - kidney stones, fluid backup due to blockage downstream |
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Term
What are common first s/sx of kidney dx? |
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Definition
HTN, pulmonary edema, HA, swelling of legs, nausea and vomiting, Weight loss, itching, cognitive impairment, tendency to bleed, |
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Term
What kidney dx s/sx are related to fluid balance problems? |
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Definition
HTN, swelling of legs, pulmonary edema |
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Term
What kidney dx s/sx are due to increased levels of urea, ions, and other waste products? |
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Definition
Fatigue, HA, weight loss, nausea and vomiting, cognitive fxn loss |
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Term
What causes itching in kidney dx? |
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Definition
phosphorus levels increase |
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Term
What are the s/sx of chronic kidney dx (CKD)? |
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Definition
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Term
What products are increased in the system with decreased kidney fxn? |
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Definition
hormones and nitrogenous wastes |
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Term
What products are decreased in the system with kidney fxn loss? |
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Definition
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Term
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Definition
if the pt has s/sx of uremia |
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Term
Which organs are affected by CKD? |
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Definition
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Term
What does CKD do to the skin? |
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Definition
increased pigmentation due to hormonal changes, and pruritis |
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Term
What does renal osteodystrophy cause systemically? |
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Definition
hyperparathyroidism --> calcitrol, osteosclerosis, osteomalacia, muscle weakness |
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Term
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Definition
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Term
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Definition
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Term
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Definition
Ca Sulfate and phosphate precipitate in the sweat, ODIFEROUS, smells like a porta potty, yellow discoloration of skin |
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Term
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Definition
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Term
Who is most prone to kidney dx? |
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Definition
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Term
What is the threshold for ESRD? |
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Definition
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Term
What is the main cause of death with impaired kidney fxn? |
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Definition
cardiovascular death, stroke |
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Term
How many people are affected by ESRD per yr in the US? |
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Definition
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Term
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Definition
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Term
what are some causes of ARF? |
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Definition
hemorrhaging, shock, infections, autoimmune dx, meds |
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Term
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Definition
loss of regulatory, excretatory, and endocrine fxn of kidney |
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Term
What % of pt's will fully recover from ARF if properly treated? |
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Definition
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Term
What can pregnancy sometimes cause in the kidney? |
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Definition
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Term
What is the most common cause of ARF? |
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Definition
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Term
What is the onset of declined GFR in ATN? |
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Definition
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Term
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Definition
acute ischemic or nephrotoxic insult |
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Term
What tissue is destroyed in ATN? |
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Definition
tubular epithelial cells --> decreased ion transport |
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Term
Where do the destroyed epithelial cells go in ATN? |
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Definition
clog the tubules causing damaged vasculature from increased pressure |
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Term
What is the result of damaged vasculature in the kidney? |
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Definition
vasoconstriction, reduced urine volume, increased waste products in the blood |
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Term
What happens to endothelin, nitric oxide and PG levels in ATN? |
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Definition
increased endothelin, decreased PG and nitric oxide --> vasoconstriction |
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Term
What feedback loop causes reduced urine in ATN? |
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Definition
renin production increases --> less urine |
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Term
What is malignant hypertension? |
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Definition
uncommon form of HTN, medical emergency |
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Term
What is the tx of malignant hypertension? |
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Definition
immediate and aggressive anti-HTN therapy |
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Term
What are the s/sx of malignant hypertension? |
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Definition
BP > 120 mmHg, ONH edema, scotoma, encephalopathy, renal failure, CV (cardiovascular) abnormalities |
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Term
What is the pathophysiology of malignant hypertension? |
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Definition
vascular damage to kidney --> increased permeability of small vessels --> fibrosis of vessels --> narrowing of vessel lumun --> ischemia of kidney --> renin release --> even further vasoconstriction |
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Term
What are specific mechanism for meds to cause ARF? |
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Definition
Type 1 and Type IV hypersensitivity (hapten), med causes toxicity |
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Term
What can cause ARF through medication toxicity? |
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Definition
aminoglycosides cause 10% of pt's to have nephrotoxicity |
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Term
What is the timing of ARF onset after aminoglycoside regimens are started? |
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Definition
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Term
What is the prognosis for ARF due to aminoglycoside nephrotoxicity? |
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Definition
very good change for recovery |
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Term
What cause of ARF is NOT dose related? |
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Definition
Type 1 and Type IV hypersensitivity |
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Term
What cause of ARF IS dose related? |
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Definition
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Term
What can NSAID's cause in the kidney? |
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Definition
decreased PG --> vasoconstriction --> ARF |
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Term
What can radiographic contrast agents cause in the kidney? |
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Definition
ARF in up to 76% of pt's who take it |
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Term
What are risks for taking radiographic contrast agents? |
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Definition
pt's with pre-existing renal insufficiency |
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Term
What is a common precaution taken when using radiographic contrast agents? |
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Definition
IV to prevent dehydration |
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Term
Can radiographic contrast agents cause hypersensitivity rxns? |
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Definition
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Term
What dz's are related to glomelular dysfunction? |
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Definition
nephrotic syndrome, nephritic syndrome, membranoprolifereative glomerulonephritis |
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Term
What are s/sx of nephrotic syndrome? |
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Definition
massive proteinuria, edema (eyelids first), hypoalbuminemia, hyperlipiduria and hyperlipidemia |
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Term
What is nepthrotic syndrome? |
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Definition
derangement of glomelular capillary walls |
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Term
What causes the body to produce increased plasma proteins and lipoproteins? |
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Definition
hypoalbuminuria due to nephrotic syndrome |
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Term
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Definition
If skin is depressed manually, it will remain depressed after removing the source of pressure. |
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