Term
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Definition
Function: Filtration → Reabsorption → Excretion
Every 24 hours 187L is filtered. 1% of filtered blood is excreted (1.5L). |
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Term
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Definition
Kidney is a excretory organ: creatinine, urea nitrogen, uric acid, inorganics (major components of urine.
Kidney is an endocrine organ: Renin, Prostaglandin, Erythropoietin
Erythropoietin: stimulates the bone marrow to produce RBC's
Renin and Prostaglandin: blood pressure regulation for hemostasis |
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Term
| What happens if you have too much acid in the blood. What happens to the H+ ions? |
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Definition
Trapping the H+ ions: NH3 + H ions = NH4 +
HPO4 -2 + H+ ions =
H2PO4-1 |
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Term
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Definition
| few urine: they might have kidney stones, it progressive and takes a while to develop. |
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Term
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Definition
| a lot of urine: they have drank a lot of water, so everything is leaky (nephrotic syndrome) |
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Term
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Definition
| Fluid used for Dialysis: Dialysate which has aluminum. Patients on Dialysis may develop Dialysis Dementia: Rapid lowering of Na ion which leads to a headache → seizure → myocardial toxicity → death |
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Term
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Definition
1. Hemodialysis: Outpatient visits
2. Peritoneal: Home treatment
- Less effective in removing K ions
- Patients may develop hyperkalemia |
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Term
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Definition
BUN: Blood Urea Nitrogen
Creatinine
BUN/Creatinine Ratio
Uric Acid
Creatinine Clearance Test
Others
Electrolytes
Glucose Osmolality
Others |
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Term
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Definition
Forms 75% of all non-protein nitrogen (NPN) containing compounds in urine
Urea in the body is secreted: 90% in Kidneys and 10% through the skin & GI tract |
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Term
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Definition
| Urea is made in the liver, so if you have severe liver disease then you are not making Urea. |
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Term
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Definition
Plasma- no hemolysis, they don't have to be fasting
NaF: inhibits glycolysis by inhibiting the enzymes most testing requires enzymes which will not give any results
Serum is best because it separates the cells from the plasma |
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Term
| Urea Direct Method (Feoron Rxn) |
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Definition
| Urea + Diacetyl monoxime -(heat)→ Diazine colored complex and that the absorbance |
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Term
| Urea Indirect Method (Berthlot Rxn) |
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Definition
| Urea -(urease)→ 2 NH3 + H2O , then measure using ISE or you can mix NH3 with phenol to produce a color change |
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Term
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Definition
picric acid or picrate → yellow complex
creatinine + picrate will give a reddish color
1. Take Absorbance (picrate reacts with protein, glucose, ascorbic acid & creatinine)
2. Stop reaction
3. Add acid (breaks down the picrate/creatinine complex)
4. After 30 mins. Take 2nd
5. Subtract 1st absorbance (total) from 2nd absorbance (picrate/glucose, protein & ascorbic acid) = creatinine level |
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Term
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Definition
| Creatininase, will break down creatinine into Ammonium and then you can measure the amount of ammonia produced by ISE |
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Term
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Definition
Normal CC = 117-125 mL/min or GFR: glomerular filtration rate
Normal GFR is 187mL/day |
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Term
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Definition
You need to consider the BUN/ Creatinine Ratio to determine the problem
-normal 12-16 to 1 |
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Term
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Definition
If you see a ↓ ratio then it indicates tubular necrosis, low protein intake, starvation and severe liver disease
↑ Plasma Nitrogen level: Azotemia → diet and dehydration
↑ BUN/Creatinin Ratio w/ Normal Creatinine, which means there is no kidney problems (pre-renal Azotemia)
- too much protein in diet or high protein catabolism, after a GI hemorrhage
liver cancer
↑BUN/Creatinine Ratio w/ ↑ Creatinine, which means there is a kidney stone blocking the flow of the urine and a build-up of the chemicals (post-renal) |
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Term
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Definition
| due to alteration in the glomerula, this leads to proteinuria (Albumin) larger proteins |
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Term
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Definition
| significant glomerular damage, this leads to proteinuria (globulin) smaller proteins |
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Term
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Definition
| reabsorption disorder in the tubules, this leads to B2-microglobulin, lysozyme or light chain immunoglobulins excretion |
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Term
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Definition
Given immunosuppressants: they inhibit the immune system from working to minimize the host immune response to new kidney.
Urine: B2- microglobulin and N. acetyl glucosaminadase indicates renal transplant rejection. |
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Term
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Definition
[image]
Uric Acid aka urate bound to sodium in urine because uric acid in urine is in crystal form |
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Term
| Uric Acid Salvage Pathway |
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Definition
| Hypoxanthine-guanine phosphoribosyl phosphatase is used to convert xanthine to guanosine. |
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Term
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Definition
elevation of uric acid
Causes:
- Dehydration
- Over production of DNA by
- Intake
- Production by cells
- Cancer followed by chemotherapy
- Defect in Salvage Pathway
- Kidney disorder that prevents the excretion of uric acid
Uric Acid degradation disorder
urate will be deposited in the joints
- stimulates inflammatory response
- Crystals form in the joints because urates combines with sodium aka Gout
- Primary
- Secondary |
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Term
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Definition
| reabsorption failure, when you have high uric acid in urine and low uric acid in the blood |
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Term
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Definition
Urolithiasis
- Kidney stones
- UTI from blockage caused by kidney stones |
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Term
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Definition
(If pt is excreting ‹2-0mg per day)
Caused by:
- low uptake and low synthsis of DNA and liver disease |
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Term
| Secretion or Overproduction of Uric Acid |
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Definition
Serum UA ↑ Excretion or Overproduction?
If pt is excreting ‹ 600mg per day of uric acid
Treatment: uricos uric drugs- inhibits renal reabsorption of uric acid
If pt is excreting › 600mg per day of uric acid
Treatment: allopurinol- inhibits the xanthine oxidase (32:30) |
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Term
| Lab Analysis of Uric Acid |
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Definition
Bacterial Infection could cause a falsely decreased uric acid uria because bacteria produces uricase.
Normal pH of urine is 5 or 6: urate becomes a precipitate |
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