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20 Cards in this Set

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When does kidney disease manifest?
Not until the GFR is 10-15%
How does creatinine change in kidney function problems?
Serum creatinine goes up; urine creatinine goes down.
What are 4 lab ways to measure kidney function?
-Serum creatinine
-Urine Creatinine clearance and BUN
-Inulin clearance (GFR)
-Nuclear medicine studies (GFR)
3 types of acute renal failure:
-Prerenal
-Intrarenal
-Postrenal
What does prerenal ARF mean?
The ARF is caused by a sudden and severe drop in BP (shock) or bloodflow via injury/illness.
What does intrarenal ARF mean?
The kidney disease is due to direct damage to the kidneys
What is postrenal ARF?
Sudden obstruction of urine flow
What is the BUN/Cr ratio normally?
10
What does it tell you if the BUN/Cr ratio is elevated, like 25?
That a person is dehydrated
Why does renal failure occur in dehydration?
Because their glomerular hydrostatic pressure is low due to decreased blood volume, so less filtration occurs.
So what type of ARF is dehydration?
Prerenal
What is the approximate MAP range for renal autoregulation?
50-150 mm Hg
What happens if MAP goes below 50, say during surgery?
GFR doesn't remain normal; it starts to fall, and results in reduced renal output.
Why is it bad when bloodflow to the renal outer medulla of the kidney falls below normal?
Because the outer medulla has a very high O2 consumption rate, higher than anywhere else actually. If there is not enough O2, necrosis ensues.
How can you tell if Acute Tubular Necrosis has occured?
You'll see cellular casts in the urinalysis.
What type of ARF is acute tubular necrosis?
Intrarenal.
Why does post-strep glomerulonephritis occur?
Because Ag-Ab complexes insert themselves in the glomerulus.
What do SMALL changes in creatinine represent?
Huge changes in GFR!!!
Why?
Because we have sooo many nephrons, we have a huge reserve in how we can handle serum creatinine.
What can cause postrenal ARF?
-Tubal ligation gone wrong
-Kidney stones