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25 Cards in this Set
- Front
- Back
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What are some of the effects of renal failure on the body?
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Loss of fluid, electrolyte homeostasis
Endocrinefunction lost Accumulation of metabolic toxins |
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What are some associated syndromes with renal failure?
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Elevated BUN
Elevated creatine Uremia: signs and symptoms of toxin accumulation |
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What is a normal GFR? GFR in ESRD?
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>90
<15 |
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What is the only solution for ESRD?
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Transplant!
Surgery FTW! |
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What are the most common causes of kidney failure?
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DM
HTN |
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If the charge barrier is lost at the glomerulus, what will be seen in the urine? Why? Is this a permanent change?
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Albumin
It's kept out of the urine by a negative charge on the glomerulus No - the charge barrier can come back by tx. with steroids |
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If the size barrier on the glomerulus is lost, what is the effect? Why? Is this reversible?
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Albumin, IgG
Not really reversible - damage to the glomeruli is more permanent |
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What is the overall effect of proximal tubular dysfunction?
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Decreased protein reabsorption
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What is the finding on urinalysis in proximal tubular dysfunction?
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Proteins found in the urine that aren't normally found in the urine: lysozyme, albumin
Also, electrolytes in the urin that aren't normally: glucose, bicarb, AAs |
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What are some possible causes of proximal tubular dysfunction?
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Tubulo-interstitial disease due to allergic interstitial nephritis
Sickle cell disease Analgesic neuropathy Light chain deposition disease Faconi syndrome |
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What is the mechanism behind overload proteinura?
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Increased concentraion of small, filterable serum proteins cause by plasma cell dysplasias (multiple myeloma)
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What are the urine findings in overload proteinuria?
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IgG light chains
Normal urine dipstick for protein |
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What is orthostatic proteinureia? When are protein levels highest?
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High protein in the afternoon, normal in the morning
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What are some causes of functional proteinuria?
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High fever
CHF Cold exposure |
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What levels of protein in the urine suggest a glomerular origin?
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3.5 g/24hr.
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What is the definition of a nephrotic syndrome?
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Proteinuria
Hypoproteinemia Edema Hyperlipidemia (a response by the liver...trying to keep up oncotic pressure) |
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What is the definition of a nephritic syndrome?
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Hematuria + proteinuria
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What is the clinical presntation of nephrotic syndrome?
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Non-inflmmatory glomerulopathy
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What are some secondary complications to nephrotic syndrome?
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Hypercoagulability
Increased infection incidence Accelerated atherogenesis |
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What is the generalized treatment for nephrotic syndromes?
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Steroids
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What are the secondary treatments for nephrotic syndrome?
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Reducing proteinuria (ACEIs, ATII receptor antagonist, protein restricted diet)
Control HTN Tx. hyperlipidemia Reduce edema |
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What is the clinical presentation of nephritic syndrome?
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INflammatory glomerulonephritis
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What are the physical characteristics of nephritic syndromes?
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Microscopic hematuria (casts, funny RBCs)
Proteinuria HTN Edema |
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Is nephritic syndrome acute or chronic?
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Acute
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Is nephrotic syndrome acute or chronic?
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Chronic
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