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37 Cards in this Set
- Front
- Back
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What's the measure we use for acute renal failure?
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BUN/Creatinine ratio
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What is the response of the kidney to BUN?
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Reabsorbed within the nephron for the countercurrent multiplier
Creatinine isn't. |
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What's the definition of acute renal failure?
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Abrupt decline in renal function with increased creatinine and increased BUN over a period of several days
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What's the cause of prerenal azotemia?
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Decreased renal blood flow-->decrased GFR
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What are the different kinds of acute kidney injury?
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Prerenal azotemia
Intrinsic renal failure Postrenal azotemia |
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What's the response of the kidney to prerenal azotemia?
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Retention of Na/H2O and urea in an attempt to conserve volume
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What happens to the BUN/creatinine ratio in prerenal azotemia?
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BUN/creatinine increases
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What are the causes of intrinsic renal failure?
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Acute tubular necrosis
Ischemia/toxins Acute glomerulonephritis |
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What is the pathologic process that occurs during intrinsic renal failure?
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Patchy necrosis --> debris obstructing the tubules
Backflow results across the necrotic tubule, decreasing GFR. |
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What are the findings in the urine of intrinsic renal failure?
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Epithelial/granular casts
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What happens to the BUN/creatinine ratio in intrinsic renal failure?
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Decreased BUN/creatinine ratio
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What's the cause of postrenal azotemia?
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Outflow obstruction:
Stones BPH Neoplasia Congenital anomalies Develops only with bilateral obstruction |
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What are the changes in the urine during prerenal azotemia?
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What are the changes in the urine during intrinsic renal failure?
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What are the changes in the urine during postrenal azotemia?
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What are the consequences of renal failure?
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Na/H2O retention
Hyperkalemia Metabolic acidosis Uremia Anemia Renal osteodystrophy Dyslipidemia Growth retardation and developmental delay (kids) |
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What are the two different forms of renal failure/
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Acute (ATN)
Chronic (HTN, diabetes) |
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What are the consequences of Na/H2O retention following renal failure?
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CHF
Pulmonary edema HTn |
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What are the symptoms of uremia?
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Nausea and anorexia
Pericarditis Asterixis Encephalopathy Platelet dysfunction |
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Why is someone anemic during renal failure?
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no EPO
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What are the defects related to vitamin D in renal osteodystrophy?
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Failure of vitamin D hydroxylation
Hypocalcemia Hyperphosphatemia |
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What is a problem secondary to renal osteodystrophy?
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Secondary hyperparathyroidism
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What's a consequence of hyperphosphatemia in renal osteodystrophy?
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Independent decrease in serum Ca by causing tissue calcifications
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What's a consequence of decreased serum vitamin D in renal osteodystrophy?
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Decreased intestinal Ca2+ absorption
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Grossly, what is a sign of renal osteodystrophy?
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Subperiosteal thinning of bones on plainfilms
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What happens in autosomal dominant polyscystic kidney disease (ADPKD)?
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Multiple, large, bilateral cysts destroy the kidney parenzyma
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What's the presentation of ADPKD?
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Flank pain
Hematura Hypertension Urinary infection Progressive renal failure |
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What's the mutation in ADPKD?
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PKD1
PKD2 |
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What's the cause of death in ADPKD?
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Complications of chronic kidney disease
HTN (increased renin) |
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What are some other things that are associated with ADPKD?
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Berry aneurysms
Mitral valve prolapse Benign hepatic cysts |
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Who presents with autosomal recessive polycystic kidney disease?
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Infants
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What's associated with ARPKD?
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Congenital hepatic fibrosis
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What's an in-utero complication of ARPKD?
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Potter's syndrome
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What are concerns for a baby with ARPKD past the neonatal period?
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HTN
Portal hypertension Progressive renal insufficiency |
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What pathology occurs in medullary cystic disease?
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Tubulointerstitial fibrosis
Progressive renal insufficiency Inability to concentrate urine |
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What's the appearance of medullary cystic disease on ultrasound?
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Shrunken kidneys!
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What's the prognosis of medullary cystic disease?
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Poor.
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