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30 Cards in this Set

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  • Back
What is the breakdown product of creatine & phosphocreatine in muscle
Serum concentration of creatinine is dependent on its production as well as its ____________
Normal range of Creatinine in the body is
~ 0.7-1.4 mg/dl
Creatinine is frequently used to estimate _______
Why does eating lots of protein increase your BUN?
Protein broken down to amino acids which is broken into ammonia which is converted to urea.
Where in the body is ammonia converted in to urea?
Ammonia is metabolized in the Liver to urea.
In the dipstick urine test which lab value is most important to pharmacists monitoring kidney function?
What is a normal BUN value?
10 to 15 : 1
What does a BUN/SCr Ratio>20:1 indicate?
possible pre-renal disease (decreased effective circulating volume)
An increased BUN/SCr ratio > 20:1 implies an increased reabsorption of what?
Ratio increases in pre-renal disease due to an increase in passive reabsorption of urea with enhanced reabsorption of Na+ & H2O in the proximal tubule
Name 2 conditions that can inhibit expected rise in the BUN/SCr ratio
Liver disease or decreased protein intake
Elevations in protein in the urine indicates what?
Kidney damage
What is a normal value of protein in the urine?
Normal Excretion = up to ~ 150 mg/day protein
What is a normal albumin value in the urine?
30mg/day albumin
What does 1+ mean on a dipstick protein analysis?
30 mg/dL (200-500 mg/day) This is well above normal of up to 150mg/day
What does Trace mean on a dipstick protein analysis?
10-20 mg/dL (150-200 mg/day)

Remember normal is up to 150mg/day
On an albumin specific dipstick a value of (+) would mean what?
>2 mg/dL (>30 mg/day)
_________________ = early indicator of subclinical renal damage
When is a spot urine sample taken?
1st morning specimen after waking
A spot ratio (mg albumin/g Creatinine) <30 means what?
Normal Albuminuria*
Sally just ran 20 miles and comes exhausted and sweating into your clinic. you perform a spot urine test and her albumin level is 50mg albumin/g creatine.
What category would you place Sally's albumin?
No category. Sally just ran an marathon and maybe dehydrated. Tell herh to come back in 3 days and retest again.
Jose' s albumin level is spot tested. The value that comes back is 28. What is his albumin level classefied as?
Normal Albumin.

Normal is < 30 mg albumin/g creatinine
Jennifer has a routine spot test performed on her albumin. The level comes back as 228. How would you assess this?
Jennifer's level is indicative of microalbuminurea but 2 out of 3 posistive tests are needed to diagnose the condition.

Microalbuminurea = 30 to 299
Raphael, who is recovering from a strep infection, is given a spot albumin test. His level comes back as 275. How would you assess this?
Raphael needs to be retested in a week when he is feeling better. Recent infection can interfere with the spot albumin test.
Raphael returns to the clinic a week after his infection has ended. His spot urine test is 306. How would you assess this?
A spot albumin level of 306 is indicative of macroalbuminuria but 2 of 3 tests must be positive to confirm the diagnosis.

Macroalbuminuria > 300mg/g creatinine
Raphael's urine sediment shows rbc cells, wbc cells and rbc casts. What does this analysis indicate?
Glomerular nephritis (infection of the glomerulus).
Kareem has a sodium level of 45 meq/L and a urine osmolality of 276. What does this indicate?
Acute Tubular Necrosis

Sodium > 40 meq/L
Urine Osmolality < 350 - 450 (less concentrating ability of the kidneys).
Will a patient with ATN have higher or lower fractional excretion of sodium.
Higher. Lost concentrating ability. Damage to tubules can't reabsorb sodium, so more is secreted than normal.
Raphael is taking smz/tmp for his infection and his Scr comes back as 2.0. What assessment would you make?
No assessment can be made. Raphael is using Smz/TMP. The trimethoprim can competitively inhibit his tubular secretion of creatinine leading to increased creatinine levels. His Scr should be taken about a week after he stops using the SMZ/TMP.
Will Raphael's Scr be higher in the morning or the evening or does time of day matter?
Peaks in PM. Be consistant in the time of day you measure a patient's Scr if you are doing continuous monitoring.