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10 Cards in this Set
- Front
- Back
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Post-renal failure
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Obstruction from ureters to urethra (stones, clots, cells, fibrosis)
Anuria, oliguria or polyuria Ultrasound: usu hydronephrosis, CT if retroperitoneal fibrosis |
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Pre-renal failure
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History of fluid loss/dec fluid intake
Normal kidney; dec EAV, renal vasoconstriction to maintain GFR Avid conservation of fluids and salts FE Na <1% (retaining Na) |
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FE Na
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FE = (UNa x PCr)/(PNa x UCr)
Pre-renal: <1% ATN: >1% |
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Volume Depletion and UNa, UCl
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High UNa and Cl: Adrenal insufficiency, renal salt wasting, diuretics
High Na, low Cl: Non-resabsorbable anions (HCO3, pen, ketoacids) Low Na, high Cl: Inc NH4Cl (chronic diarrhea) |
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Pathogenesis of ATN
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Tubular cell death due to ischemia or nephrotoxic agents (contrast, rhabdomyolysis, NSAIDs esp if dec EAV)
Reversible failure |
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Oliguric ATN
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Urine <400 mL/day
Progressive inc phosphorus, BUN, Cr, K, acidosis Predisposed to infections |
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Non-oliguric ATN
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Urine >400 mL/day
Less severe renal injury than oliguric (usu mild ischemia or toxins) |
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Thromboembolic diseases
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Asymptomatic, nausa, vomiting, flank pain, fever, hematuria
Inc BP shortly after acute infarct (RAAS response to ischemia) Inc LDH (up to 5 x normal) Renal vein venography to show dec perfusion |
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Renal vein thrombosis
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Nephrotic syndrome inc incidence
Often presents with PE, less often signs of renal infarction |
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ACEI or ARB-induced renal dysfunction
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GFR is dependent on AII activity due to dec pressure/flow (renal artery stenosis, PCKD, volume contraction)
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