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15 Cards in this Set
- Front
- Back
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List two hormone problems that CKD (chronic kidney disease) can cause
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CKD can cause dec'd erythropoiesis, so we supplement EPO (erythropoietin)
CKD can prevent activation of vitamin D, and since vit D promotes Ca+ and PO4 absorption in the gut, we could have decreased absorption of these |
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What do prostaglandins do in the kidneys?
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Prostaglandins are vasodilators in the kidneys
note: drugs that inhibit pg synthesis can cause dec'd renal blood flow |
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Whats the most accurate measure of GFR, but is rarely used due to cost?
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Inulin
Filtered by the kidney, but not secreted or reabsorbed |
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Why is creatinine less accurate that inulin for measuring GFR?
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Creatinine is filtered and secreted, so it's an overestimate of the GFR
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What is another means of measuring GFR, but is rarely used due to several factors that can modify its serum levels?
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BUN (blood urea nitrogen)
Filtered and reabsorbed by kidneys |
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What are the different estimations of body weight that we can substitute into cockcroft-gault?
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Actual body weight
Ideal body weight Adjusted body weight |
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How do you calculate IBW (ideal body weight)?
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Men: 50kg + 2.3kg for each inch over 5 feet
Women: 45.5kg + 2.3kg for each inch over 5 feet |
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How do you calculate adjusted body weight?
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Adjusted body weight = IBW + 0.4(ABW-IBW)
note: ABW is actual body wgt |
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Whats the cockcroft-gault equation?
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Clcr = ((140-age) x wgt) / (SCr x 72)
multiply by 0.85 if female |
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Is IBW generally higher or lower than ABW for overweight people?
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Lower, because the fat weight is factored out
IBW estimates lean body mass (muscle mass), because muscles produce creatinine, not fat |
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Whats another system for measuring GFR based on SCr other than cockcroft-gault?
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The modified MDRD equation
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Whats the MDRD equation?
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GFR(not Clcr) = 186 / (SCr^1.154 x Age^0.203)
multiply by 0.742 if female multiply by 1.212 if black multiply by both if black female |
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Main disadvantage of MDRD over cockcroft-gault?
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MDRD gives an overestimate of the GFR in the elderly
So, MDRD value might seem like elderly persons GFR is fine, when its actually low |
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What are the top three most accurate methods to estimate renal function?
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Inulin
MDRD 24hr urine collection |
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Whats the equation for 24hr urine collection?
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Clcr = (uCr x uV) / (sCr x 1440)
where uCr = amt of creatinine in the urine (mg/dl) uV = urine volume in ml 1440 = minutes in 24 hours |
