• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/219

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

219 Cards in this Set

  • Front
  • Back
The renal systems primary functions are
regulation of fluid and electrolytes, regulation of acid/base balance
These electrolytes are regulated by the kidneys
sodium, K, hydrogen, bicarb, calcium, chloride
The kidney regulates plasma _____ through influence of the ADH hormone.
osmolality
The kidneys regulate blood pressure via the elimination of ...
aldosterone, water, Na
Endocrine function of the kidney is through activation of :
Vitamin D, renin, and erythropoietin
Metabolic wastes eliminated by the kidneys include...
BUN, creatinine, uric acid, drugs
The kidneys lie (inside/outside) the peritoneal cavity in the back of the upper abdomen at the spinal level of _____. The ____ kidney is lower than the ____.
outside, T12-L3, right lower than left
Kidney outer cortex contains
glomeruli, convoluted tubules of nephron, blood vessels
Inner medulla of kidney contains
renal pyraminds, renal papillae, renal pelvis
The nephron is responsible for
renal blood flow
Describe the order of renal blood flow
renal artery--> afferent arteriole--> glomerular capillaries --> efferent arteriole --> peritubular capillaries --> venules --> renal vein
What are the 2 renal capillary systems and what do they do?
glomerulus- high pressure, filters blood
peritubular- low pressure, absorption/secretion between blood and filtrate
Describe the flow of filtrate
bowmans capsule--> proximal convoluted tubule --> descending limb of henle --> loop of henle--> ascending limb of henle --> bowmans at JGA --> distal convoluted tubule --> collecting tubule
____ membrane determines permeability of glomerular capillary membrane. It prevents passing of ___ and _____, and in glomerular diseases, ____ is altered.
Basement, RBCs, Proteins, structure/function
What does the proximal tubule do to filtrate?
reabsorb: Na, Cl, HCO3, K, H20, glucose, amino acids
secrete: H, organic acids and bases
What does the thin descending loop of henle do to filtrate?
reabsorbs water
what does the thick ascending loop of henle do to filtrate?
reabsorb: Na, Cl, K, Ca, HCO2, Mg
secrete: H
what does the early distal tubule do to filtrate?
reabsorb: Na, Cl, Ca, Mg
What doe the late distal tubule and collecting duct do to filtrate? (principal and intercalated cells)
principal- reabsorbs Na and Cl, secretes K, ADH mediated H20 reabsorption
intercalated- reabsorbs HCO3 and K, secretes H
GFR movement is determined by
capillary hydrostatic pressure, colloidal osmotic pressure, membrane permeability
What is normal GFR?
110-125 mL/min
What are the neurohormonal mechanisms for regulating renal blood flow?
- SNS constricts both afferent and efferent arterioles causing decr. in RBF and GFR
- Angiotensin II and ADH produce vasoconstriction of renal blood vessels causing decrease in RBF
- prostaglandins and NO cause vasodilation protecting kidneys during intense SNS stim.
______ keeps RBF and GFR constant despite fluctuation fo BP
autoregulation
myogenic response
change of diameter of afferent and efferent arterioles depending on stretch of afferent arteriole
glomerular-tubular feedback
in juxtaglomerular complex, amt. of NaCl in macula densa is monitored
When GFR decr. due to lower arterial pressure, the macula densa recognizes a decrease in ______, causing these 2 results:
NaCl,
incr. renin release and decr. afferent arteriole resistance
When efferent arteriole resistance is increased and afferent arteriole resistance is decreased....
there will be an increase in glomerular filtration pressure
In renal reabsorption, what is able to cross the capillary membrane under active and passive tranport?
active- Na, K, Cl, Ca, phos, glucose, AAs
passive- water, urea (conc. gradients)
___ and ____ are secreted, and most ____ is reabsorbed.
H and K, fluid
3 renal transport mechanisms
secondary active: Na-K pump, ATP dependent
cotransport: Na, Glucose/AA
antiport: Na, H
renal threshold
plasma level at which the substance appears in the urine; amount in glomerulus exceeds transport maximum
When blood glucose and the amount filtered by the kidneys increase, the max transport is exceeded resulting in...
glucosuria
What is the effect of aldosterone on the kidney elimination?
increased reabsorption of Na and water
What is the effect of ANP and BNP on the kidney?
increased water and Na excretion
The kidneys regulate pH via ____ elimination
H ion
Other than electrolytes and water, kidneys also eliminate:
urea, creatinine, uric acid, drugs
BUN
urea end product of protein metabolism; depends on renal excretion, protein metabolism, dietary protein intake, and volume status
Increased BUN synthesis results from
TPN, catabolic state, GI bleed, steroids, muscle breakdown
Decreased BUN synthesis results from
malnutrition, liver failure, volume expansion
Muscles release ____ at a basal constant rate depending on muscle mass. The kidneys then ____ and minimally ___ it.
creatinine, filter, secrete
_____ is a more reliable index than BUN of renal function
Creatinine
Creatinine is affected by muscle injuries such as
trauma, crush, burn
Normal BUN:Cr ratio is
10-15:1
Creatinine clearance reflects the _____ and should be ____ mL/min
GFR, 120 mL/min
The _____ the creatinine, the worse the renal function.
higher
Erythropoietin is
a hormone that regulates RBC production in bone marrow; made in kidneys and stimulated by hypoxia
Vitamin D hormone
transformed to active form by kidneys, increases calcium absorption from GI tract
Loop diuretics
act on thick ascending loop of henle, accounts for 20% of filtered sodium reabsorption
Osmotic diuretics
acts on proximal tubule, accounts for 65% of filtered sodium reabsorption
thiazide diuretics
acts on early distal tubule, accounts for 10% of filtered Na reabsorption
K-sparing diuretics
acts on the distal tubule, accounts for 2-5% of filtered Na reabsorption
Total body water accounts for ___ % of body weight. This is further split into ___ % intracellular water and ____% extracellular water.
60%, 40%, 20%
electrolytes
substances that dissociate in solution to form charged particle (ion), opposites attract; cations and anions
diffusion
movement of particles down a concentration gradient from high to low conc.
osmosis
movement of H20 across semi-permeable membrane; particles "pull" H20 by #, not size; osmotic pressure is expressed in mOsm/L

osmolarity= osmolality
Tonicity is compared to that of plasma, and can be divided into 3 categories:
hypotonic- decr. osmolarity than intracellular fluid
isotonic - same osmolarity as intracellular fluid
hypertonic- higher osmolarity than intracellular fluid
In isotonic solution, the cell ____, in hypertonic the cell _____, in hypotonic the cell _____.
stays same, shrinks, expands
Normal chloride level
98-106
normal bicarb level
24-31
normal calcium level
8.5-10.5
normal phos level
2.5-4.5
normal mag level
1.8-3.0
___ controls extracellular fluid osmolality, and it is proportionate in change to ____ volume.
Na, water
Most Na is in the ____ fluid compartment. The resting cell membrane is ___ to Na, so it must be transported by this energy dependent pump:
extracellular, impermeable, Na-K-ATPase pump
____ determines ECF volume and osmolality, helps in regulation of blood pH, and contributes to nervous system function.
Na
Na enters through _____, unless youre hospitalized and then you will get it from ___ and ___.
GI tract, meds and IVF
Na is eliminated by
kidneys (most), GI tract (vomiting, diarrhea, fistula, suction), skin (Sweat, burns)
How much Na is required daily?
500 mg
The ____ is the main regulator of Na, and it is coordinated by these 2 systems.
kidney, SNS, RAAS
When BP drops, Na will be
retained
ANP and BNP are released in response to atrial stretching, resulting in an increase in
Na excretion (natriuresis)
How is water gained and lost?
gain- oral intake, absorbed in GI tract
loss- kidneys, GI tract, skin, lungs (insensible), sweating
____ is a regulator of water intake that responds to ECF changes in osmolarity and volume. It is a conscious sensation due to emergency response of low volume, and can be caused by diarrhea, vomiting, DM, DI.
thirst/polydipsia
ADH
regulator of output, responds to ECF changes in osmolarity and volume, acute conditons produce greater changes than chronic conditions
____ is released by the osmoreceptors in the hypothalamus to decrease urine concentration and flow.
ADH
DI
deficiency or decrease response to ADH, can be neurogenic (stroke, head injury, surgery), nephrogenic (lithium, amiloidosis), or gestational (breakdown of ADH);
large diluted urine output 40L/day, thirsty;
can maintain volemia if maintain input of H20
An isotonic fluid deficit results in
decreased extracellular fluid and decreased circulating blood volume
Mechanisms of isotonic fluid deficit:
fluid intake- oral trauma, inability to swallow, NPO, impaired thirst mech, decr LOC
GI- vomiting, diarrhea, suction, fistula, small bowel dz
Renal- diuretics, osmotic diuresis(incr glucose), kidney disease
skin- fever, exposure to heat/burn, wounds
third space loss
An isotonic fluid excess results in
increased ECF and increased circulating blood volume
Mechanisms of isotonic fluid excess:
decr Na and H20 elim
incr Na intake
incr. fluid intake

(heart, renal, liver failure, meds, IVF, speed of ingestion r/t output)
2 mechanisms of hyponatremia (Na < 135, Serum Osmo < 275)
decr serum Na, incr H20 (dilutional)
Serum sodium loss may be due to
sweating, GI loss, diuretics
Dilutional hyponatremia
H20 shifts from cells to ECF in hyperglycemia, excess IV/PO h20 intake, or water retention (CHF, ARF, cirrhosis, incr ADH)
S/S of hyponatremia
cramps, weakness, fatigue, nausea, vomiting, diarrhea, headache, confusion, lethargy, seizures, coma
2 mechanisms of hypernatremia (Na> 145, serum osmo > 295)
decr. H20, incr. Na
Serum H20 loss may be due to
diarrhea, sweating, incr RR, DI, or decr. intake (drought, physical impairment, thirst impaired, NPO, unconscious)
Incr. serum Na due to
rapid/excess IVF, salt water near drowning, meds
S/S hypernatremia
cellular dehydration, incr thirst, decr urine output, incr urine osm, dry mucous membranes, fever, decr. reflexes, agitation, headache, restlessness, coma, seizures

Na alterations = NEURO alterations
Potassium
mainly intracellular, intake through diet sources, lost via kidneys (90%), urine, sweat, stools
function: regulate electrical membrane potentials controlling excitability of skeletal, cardiac and smooth muscle tissue
regulated through renal system and ICF/ECF shifts
The Na-K-ATPase pump is influenced by ___ and ____, and increased cellular uptake of K occurs by increase in pump activity.
epi, insulin
How does pH influence K shifts
acidosis - H moves into cells to maintain electrical neutrality, as H goes into cell, K comes out
Shifts of K can result in ____ muscle activity.
excessive, clenching
Hypokalemia
K < 3.5
due to decr .diet intake,incr losses (vomiting, diarrhea, sxn, burns, diuretics, SNS stress), redistribution during acidosis
S/S of hypokalemia
NVD, decr bowel sounds, weakness, fatigue, cramps, EKG changes, confusion, depression, decr neuromusc excitability
Hyperkalemia
k > 5,
due to incr diet intake or IVF, redistribution (cell trauma, death, burns, injuries, extreme exercise, seizures), decr. elimination (renal failure, K sparing diuretics, ACE inhibitors
S/S of hyperkalemia
neuromuscular excitability, EKG changes
This electrolyte imbalance leads to prolonged PR, depressed ST, prominent U wave
hypokalemia
This electrolyte imbalance leads to low P wave, wide QRS, and peaked T wave
hyperkalemia
acid
molecule that can release H
base
molecule than can accept H
Chemical buffer system
proteins that consist of weak acid and its base or weak base and its acid
H2CO3 = H + HCO3
This equation is important for acid/base calculations
henderson-hasselbach
3 major mechanisms to regulate pH
chemical buffers, respiratory control, renal control mechanisms
How does a buffer system work
substitutes a strong acid or base for a weak acid or base preventing big changes in pH
3 buffer systems in body:
bicarbonate, proteins binding/releasing H (amphoteric), H/K exchange
3 ways CO2 can be transported
dissolved CO2, HbCO2, HCO3
Respiratory system is stimulated by the ____ center, and regulates carbonic acid concentration by change in ______.
chemotactic control,
rate and depth of respiration
which is greater, acid or base production?
acid
Renal regulation of pH
regulated through excreting acid or alkaline urine, and can function for days before pH returns to normal, pH control occurs in proximal tubule; can regenerate HC03 and secrete H
What are the tubular buffer systems
ammonia, phosphate
Hypochloremia results in _____, hyperchloremia results in _____. (pH)
alkalosis, acidosis
base deficit
amount of base that must be added to blood sample to achieve pH 7.4 (normally +/- 3)
anion gap
-difference between cations and anions
-increased in lactic acidosis/ketoacidosis)
-decreased in fall in unmeasured anions (albumin) or rise in unmeasured cations (K, ca, mg)
Metabolic acidosis
decr pH due to decr HCO3
metabolic alkalosis
incr pH due to incr HCO3
respiratory acidosis
decr pH due to decr in ventillation and increased in PaCO2
respiratory alkalosis
incr pH due to incr alveolar ventillation and decr PaCO2
Compensatory mechanisms adjust pH toward normal (7.4) but don't
correct underlying issue
Respiratory system compensates for abnormal pH by
incr or decr ventilation
Kidneys compensate for abnormal pH by
conserving HCO3 or H ions
Compensatory mechanisms
interim measures that permit survival while body attempts to correct primary disorder; requires mechanisms different than those that caused primary disorder

resp mechanisms compensate for renal induced, and renal mech compensate for resp induced
If pH is within normal limits but other parameters are not...
complete compensation
Causes of metabolic acidosis
- incr production of metabolic acids
- decr acid secretion by kidneys d/t renal fx
- incr loss of HCO3
- incr in chloride
Causes of metabolic alkalosis
- incr HCO3 (IVF, blood tx)
- decr H ions (vomiting)
- volume depletion
Causes of resp acidosis
- depr of resp center (OD, head injury)
- lung disease (asthma, emphysema, pneumonia, pulm edema)
- airway obstruction, abnormal chest wall motion, resp muscles
- breathing air with high CO2 content
Causes of resp alkalosis
excessive ventillation due to
- anxiety/psychogenic
- hypoxia with reflex stim of incr ventilation
- stimulation of resp center (Ammonia levels, salicylate toxicity, fever)
- mech ventillation
_____ control formation of urine and regulate composition fo body fluids
kidneys
The ____ Stores urine and controls its elimination from the body
bladder
Components to bladder stucture
-outer serosal layer
- detrusor muscle (smooth muscle)
- submucosal layer of loose connective tissue
- inner mucosal lining of transitional epithelial cells (barrier to prevent passage of water between bladder contents and blood)
This is the muscle of micturition, ____ contracts it and ____ relaxes it.
detrusor, PNS, SNS
When abdominal muscles contract and intra-abdominal pressure goes up...
bladder pressure goes up
Bladder internal sphincter
circular muscle in neck, continuation of detrusor, fibers closed when bladder relaxes, sphincter pulled open by change in bladder shape during contraction
Bladder external sphincter
circular muscle surrounds urethra, acts as reserve mechanism to stop peeing, maintains continence despite incr bladder pressure, under voluntary control by somatic NS
As bladder filling occurs, ascending spindle fibers relay info to center, which also receives input from forebrain about
behavior cues for bladder emptying
Coordination of micturition reflex occurs in the _____, facilitated by input from forebrain and SC reflexes. This coordinates activity of detrusor and external sphincter.
pontine micturition center
Descending pathways from pontine micturition center produce coordinated inhibition of somatic systems, resulting in ______. The onset of urinary flow through urethra causes reflex _____ of the bladder.
relaxation of both sphincters, contraction
Describe the events leading to urination:
bladder fills--> stretch receptors stimulated --> pelvic nerve carries impulses to sacral spinal cord --> micturition center stimulated --> parasympathetic motor neurons send impulses to detrusor muscle through pelvic nerve --> detrusor muscle contracts --> PEE!
Infant/children micturition is _____, triggered by ___ reflex.
involuntary, SC
As bladder increases in capacity, so does the tone of
the external sphincter.
At ____ yrs, child becomes conscious of need to urinate and can learn to contract pelvic muscles to maintain closure of sphincter and delay urination. As nervous system continues to mature, inhibition of involuntary _____ takes place.
2-3 yrs, detrusor muscle activity
2 types of alteration in bladder elimination function
neurogenic bladder disorders
urinary incontinence
neurogenic bladder disorder
failure to empty, flaccid bladder;
results from neuro disorder affecting motor neurons in SC or peripheral nerves that control detrusor muscle contraction and bladder emptying;
peripheral neuropathies, injury to cauda equina, trauma, tumors, spina bifida;
no voluntary emptying of bladder -- good emptying achieved by incr intraabdominal pressure or manual suprapubic pressure
stress incontinence
invol loss of urine assoc w activities that incr IAP (coughing)
overactive bladder
urgency, frequency assoc w hyperactivity of detrusor; may/may not involve invol. loss of urine
overflow incontinence
invol. loss of urine when bladder pressure > urethral pressure in absence of detrusor activity
Stress incontinence in women
loss of posterior urethrovesical angle (should be 90 degrees), due to aging, childbirth or surgery that loses critical angle and pelvic floor tonus
overactive/urge incontinence is caused by involuntary loss of urine associated with _____ and is caused by involuntary ______.
a strong desire to void (urgency),
bladder contractions
S/S of overactive/urge incontinence
may have incontinece, incr frequency, dysuria, nocturia
Overflow incontinence results in a retention of urine due to _______, and small amts of urine may be passed due to ____ or ____.
neural disorders or obstruction;
fecal impaction, enlarged prostate
Factors contributing to incontinence in the elderly
-decr overall bladder capacity
-decr urethral closing pressure
-decr detrusor muscle function
-restricted mobility
-medications (Diuretics, psychoactive drugs)
Glomerular syndromes include:
nephritic and nephrotic
3 mechanisms for glomerular injury
-immunologic
- non-immunologic (DM, HTN, drugs)
- heredity
Immune glomerular injury
antiglomerular antibodies leave circulation, react w antigents present in basement membrane of glomerulus; antigens may be exogenous or endogenous --> antigen-antibody complexes become trapped in glomerulus
acute nephritic syndrome
acute glomerular inflammation, sudden onset w decr GFR, hematuria, oliguria, fluid and waste accumulation
acute postinfectious glomerulonephritis
follows infections caused by group A-B hemolytic streptococci;
inflam. response from circulating immune complexes getting trapped in BM of glomerulus, leading to oliguria, hematuria, proteinuria, edema, HTN;
treated w ABX;
children usually recover, adults more likely to have permanent damage
nephrotic syndrome
increased glomerular permeability wtih massive proteinuria, hypoalbuminemia, salt and water accumulation, generalized edema, hyperlipidemia;
accompanied by pulm edema, ascites, pleural effusions, infections, thrombotic complications
Membranous glomerulonephritis results from deposition of _____, thickening the membrane. It is often caused by:
immune complexes;
SLE, hepatitis, thyroiditis, DM, drugs
In nephrotic syndrome, there is a ___% spontaneous recovery, ____ % remission/relapse, and ____% kidney failture
40, 40, 20
systemic diseases that can cause glomerular lesions
diabetic glomerulosclerosis, hypertensive glomerular disease
This is the most common cause of ESRD, there are both type 1 and 2, ti is more prevalent among blacks, asians, native americans, and involves widespread thickening and sclerosis of GBM and mesangial cells.
diabetic glomerulosclerosis
In diabetic glomerulosclerosis, there is a defective formation of ____ with glucose incorporation, resulting in increased:
Glomerular basement membrane,
increased GFR, cap pressure, cap pores, albumin presence in filtrate, work of cells to absorb
Diabetic glomerulosclerosis inevitably leads to
nephron destruction
Urine characteristic of diabetic glomerulosclerosis:
microalbuminuria
ACE inhibitors and ARBs may help wtih diabetic glomerulosclerosis, but ____ and ____ progress the disease.
HTN, smoking
HTN is a ____ and ____ of kidney disease
cause and effect
Hypertensive glomerular disease is most prevalent in
blacks
Hypertensive glomerular diseases is the second leading cause of ESRD, is more aggressive in ______, and leads to changes in kidney structure and function due to _____ and ____ of arterioles.
people with other conditions (DM),
sclerosis and atrophy of arterioles
Acute kidney injury
condition in which kidneys fail to remove metabolic end products from the blood and regulate the fluid, electrolyte, and pH balance of the extracellular fluids; underlying cause maybe renal disease or systemic disease
kidney injury- distinguish acute injury and chronic disease
acute: abrupt, usually reversible with early tx
chronic: end result of irreparable damage to kidneys, develops over course of years
Acute kidney injury often complicates outcomes of ____ patients, with a ___% mortality, often as a result of:
ICU, 40-70%, trauma shock and sepsis
azotemia
accumulation of nitrogenous waste products in blood, (urea, BUN, creatinine)
a decr. in GFR will decr. urine excretion of wastes and increase their blood levels
pre-renal
decr renal blood flow due to hemorrhage, dehydration, shock, drugs
intrarenal/intrinsic
ATN- prolonged ischemia, nephrotoxic drugs, tubular obstuction, Hburia, myoglobinuria, acute diseases, glomerulo and pyelonephritis
post-renal
obstruction in ureter/bladder/urethra
intrarenal/intrinsic
ATN- prolonged ischemia, nephrotoxic drugs, tubular obstuction, Hburia, myoglobinuria, acute diseases, glomerulo and pyelonephritis
Kidneys receive ___% of CO to filter blood, regulate fluid and electrolyte balance.
20%
post-renal
obstruction in ureter/bladder/urethra
In prerenal injury, the kidneys will decrease ____ and ____ excretion to preserve vascular volume.
sodium, water
Kidneys receive ___% of CO to filter blood, regulate fluid and electrolyte balance.
20%
In prerenal injury, decreased renal blood flow results in
decr O2 delivery to tubular cells, and cell death
In prerenal injury, the kidneys will decrease ____ and ____ excretion to preserve vascular volume.
sodium, water
intrarenal/intrinsic
ATN- prolonged ischemia, nephrotoxic drugs, tubular obstuction, Hburia, myoglobinuria, acute diseases, glomerulo and pyelonephritis
In prerenal injury, decreased renal blood flow results in
decr O2 delivery to tubular cells, and cell death
post-renal
obstruction in ureter/bladder/urethra
Kidneys receive ___% of CO to filter blood, regulate fluid and electrolyte balance.
20%
In prerenal injury, the kidneys will decrease ____ and ____ excretion to preserve vascular volume.
sodium, water
In prerenal injury, decreased renal blood flow results in
decr O2 delivery to tubular cells, and cell death
types of postrenal obstruction
- ureters: calculi and strictures
- bladder: tumors, neurogenic bladder
- urethra: prostatic hypertrophy
These structures of the kidney may be affected by intrinsic renal injury
glomerular, interstitium, tubular
causes of Acute tubular necrosis
ischemia, toxic insult (Drugs), intratubular obstruction
ischemic ATN
destruction of tubular cells with ARF; due to major surgery, severe hypovolemia, overwhelming sepsis, major trauma, burns;
GFR does not improve with RBF restoration
Nephrotoxic ATN
nephrotoxic drugs and other agents cause it; renal vasoconstriction, direct tubular damage, intratubular obstruction; kidney is vulnerable due to blood supply and ability to concentrate toxins
causes of nephrotoxic ATN
aminoglycosides, chemo, contrast agents
with co-exisiting conditions, DM, elderly
What types of blood components can result in tubular obstruction ATN?
-myoglobin: skeletal muscle breakdown from trauma, exertion, hyperthermia, prolonged seizures, sepsis, drug abuse
- hemoglobin: blood tx rxn
- uric acid and myeloma light chains: widespread Ca, massive tumor destruction w chemo, radiation
3 phases of ATN
1- onset/initiating: lasts hours/days from onset of insult to injury
2- maintenance: decr GFR, retention of metabolites, decr serum Na, gen edema, pulm edema, metabolic acidosis
3- recovery: repair of renal tissues, gradual improvement in u/o, BUN, Cr
Stage 1 chronic kidney disease
kidney damage w normal GFR > 90
stage 2 chronic kidney disease
kidney damage w mild decr GFR 69-89
stage 3 chronic kidney disease
moderate decr in GFR 30-59
stage 4 chronic kidney disease
severe decr in GFR 15-29
stage 5 chronic kidney disease
kidney failure, GFR < 15, dialysis needed
chronic kidney disease is progressive and irreversible ________. It requires ____ or _____ for treatment. Signs and symptoms are not evident until disease is advanced!
destruction of nephrons, dialysis or renal transplant
chronic kidney disease is caused by
DM, HTN, glomerulonephritis
____ is the best measure of overall kidney function, and when it is < 60, loss of 1/2 normal kidney function is present.
GFR
This equation is used to determine creatinine clearance
cockroft and gault
Describe some end result manifestations of chronic kidney disease
HTN, edema, hyperkalemia, pericarditis, impaired immunity, skin disorders, GI manifestations, neuro manifestations, sexual dysfunction, coagulopathies and bleeding, anemia, acidosis, osteodystrophies hypocalcemia, hyperparathyroidism
____ is the best measure of overall kidney function, and when it is < 60, loss of 1/2 normal kidney function is present.
GFR
This equation is used to determine creatinine clearance
cockroft and gault
what causes chronic kidney disease in children?
congenital malformations, inherited disorders, acquireed dx, metabolic syndromes
if younger than 5, congenital renal dysplasia or obstructive uropathy
if greater than 5, acquired glomerulonephritis or inherited
Describe some end result manifestations of chronic kidney disease
HTN, edema, hyperkalemia, pericarditis, impaired immunity, skin disorders, GI manifestations, neuro manifestations, sexual dysfunction, coagulopathies and bleeding, anemia, acidosis, osteodystrophies hypocalcemia, hyperparathyroidism
The progression of chronic kidney disease in children is similar to that for adults. It is manifested by:
severe growth impairment, developmental delay, delay in sexual maturation, bone abnormalities, development of psychosocial problems
what causes chronic kidney disease in children?
congenital malformations, inherited disorders, acquireed dx, metabolic syndromes
if younger than 5, congenital renal dysplasia or obstructive uropathy
if greater than 5, acquired glomerulonephritis or inherited
The progression of chronic kidney disease in children is similar to that for adults. It is manifested by:
severe growth impairment, developmental delay, delay in sexual maturation, bone abnormalities, development of psychosocial problems
____ is the best measure of overall kidney function, and when it is < 60, loss of 1/2 normal kidney function is present.
GFR
This equation is used to determine creatinine clearance
cockroft and gault
Describe some end result manifestations of chronic kidney disease
HTN, edema, hyperkalemia, pericarditis, impaired immunity, skin disorders, GI manifestations, neuro manifestations, sexual dysfunction, coagulopathies and bleeding, anemia, acidosis, osteodystrophies hypocalcemia, hyperparathyroidism
what causes chronic kidney disease in children?
congenital malformations, inherited disorders, acquireed dx, metabolic syndromes
if younger than 5, congenital renal dysplasia or obstructive uropathy
if greater than 5, acquired glomerulonephritis or inherited
The progression of chronic kidney disease in children is similar to that for adults. It is manifested by:
severe growth impairment, developmental delay, delay in sexual maturation, bone abnormalities, development of psychosocial problems
In the elderly, chronic kidney disease may result from normal aging associated with decreased ____, and they are also more susceptible to ____ drugs. Diagnosis and course will be more complicated.
GFR, Nephrotoxic
Unlike other types of kidney disease, elderly chronic kidney disease is not associated with elevation in
creatinine