Term
| What is acute kidney injury (AKI)? |
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Definition
| ABRUPT kidney decrease in kidney function that happens on a continuum. |
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Term
| What is Acute Renal Failure? |
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Definition
| A type of injury on the AKI spectrum |
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Term
| What is classified as Chronic Kidney Disease? |
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Definition
| Decreased kidney function lasting longer than three months |
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Term
| What are the 5 regulatory functions of the kidneys? |
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Definition
1. ECF Volume
2. Blood pressure
3. Electrolyte Balance
4. Water Balance
5. Acid-Base Balance...that's a lot!!! |
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Term
| What are the 3 Endocrine functions of the kidney? |
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Definition
1. Renin (reg BP)
2. Red Blood Cell production (erythropoietin hormone)
3. Activation of Vit D. |
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Term
What is classified as OLIGURIA?
ANURIA?
RESIDUAL URINE?
Normal output:
Typical replacement in renal failure: |
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Definition
<400 mL/DAY
<100 mL/DAY
<= 50mL
1mL/Kg/Hr (1mL/min)
Urine output+600 mL |
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Term
| What is the RIFLE definition of AKI? |
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Definition
Risk of injury
Injury
Failure of kidney
***Loss of function > 4wks
End Stage Renal Disease |
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Term
| What is ARF? What is the preferred marker for ARF? |
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Definition
- Acute Renal Failure, loss of renal function over hours or days resulting in failure to excrete nitrogenous waste and loss of F/E balance.
- Creatinine levels from metabolized Pr (takes a little time for levels to rise though) |
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Term
| What are the main causes of Prerenal AKI? What is the MAP below which GFR declines rapidly? |
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Definition
- HYPOVOLEMIA (V/D, burns, blood loss)
- MAP <80 |
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Term
| Acute Tubular Necrosis is a form of _______ AKI and can result from ischemia. |
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Definition
| Intrarenal, basically the idea here is that renal pathologies are NOT mutually exclusive. |
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Term
| Normal kidneys _______ PO4- and ______ Ca++ |
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Definition
Excrete Phosphorus
Retain Calcium |
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Term
| What are the PHASES of Acute Tubular Necrosis? |
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Definition
1. Onset (1-2hrs)
2. Oliguria/Anuria (7-15 days) FLUID OVERLOAD, Increases in BUN, Cr, K, and PO4, Decreases in Ca++
3. Diurisis (slow correction of BUN/Cr, E and acid/base)
4. Recovery (slow, 5-60 days)
4. |
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Term
| Which type of AKI has the most concentrated urine? |
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Definition
| Prerenal, because the kidney's aren't perfused. |
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Term
| Which type of AKI has a fixed SG of urine at 1.010? |
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Definition
| Intrarenal, because the kidney's aren't DOING ANYTHING to regulate the urine concentration |
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Term
| Which type of AKI has the highest Na+ content in the urine? |
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Definition
| Intrenal, bc in prerenal the kidney's aren't getting enough blood to filter the Na+ out. |
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Term
Which type of AKI has BUN/Cr> 20:1?
BUN/Cr < 15:1? |
|
Definition
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Term
| AKI Considerations: What does volume of urine reflect? |
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Definition
| GFR and tubular reabsorption NOT renal failure. |
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Term
| AKI Considerations: Cr and BUN require ____ to accumulate in Sr. |
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Definition
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Term
| Estimated GFR takes into account what? |
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Definition
| Age, race, gender, body size. |
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Term
| What ratio is a sign of decreased Renal Perfusion? |
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Definition
| BUN/Cr ratio. (Sr Cr is a sign of GFR) |
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Term
| What is Chronic Kidney disease? |
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Definition
| SLOW, progressive, irreversible loss of renal function |
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Term
| What are the main causes of CKD? |
|
Definition
1. Diabetic nephropathy
2. Hypertension
3. Glomerulonephritis
4. Cystic Kidney Disease |
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Term
| What are the preventative measures to prevent CKD? |
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Definition
- Control WEIGHT. BP. BLOOD GLUCOSE.
- STOP SMOKING
- Low salt diet
- Limit alcohol intake |
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Term
| What are some measure to PRESERVE RENAL FXN for folks with CKD? |
|
Definition
In addition to the MAIN preventatives listed before:
- ACE ihi
- correct anemia
- correct Ca++ imbalances
- prevent hyperlipidemia |
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Term
| What is used to determine what stage a patient is at in the CKD continuum? |
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Definition
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Term
| What is the leading cause of death in renal failure? Why? |
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Definition
| Infection, because every cell in the body is sick. |
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Term
| What are the 8 effects of Renal Failure (loss, ESRD) |
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Definition
1. Uremia (nitrogenous waste accum. in blood resulting in neuropathy)
2. Fluid overload/osmolar imbalance
3. HYPERKALEMIA
4. hypoCalcemia (No Vit D activation in Kidney to prompt reabsorption of Ca)
5. hyperphosphatemia
6. Anemia
7. Bleeding
8. Infection |
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Term
| How do you treat anemia in Renal Failure? |
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Definition
| Give especially Erythropoietin |
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Term
| How do you treat hypocalcemia (hyperphosphatemia) in renal failure? |
|
Definition
- Dietary restrict/bind/excrete PO4
- Reduce PTH (breaks down bone to increase Ca++ levels)
- Activate Vit D |
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Term
| What foods are high in Phosphorus? |
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Definition
| Almost everything! Dairy, Beer, Chocolate... |
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Term
| How do you treat the Pruritis caused by Uremia from renal failure? |
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Definition
| Good oral hygiene, gentle cleansing, emoolients |
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Term
What CAN dialysis correct?
What CAN'T dialysis correct? |
|
Definition
+ Removes wastes, FLUID
+ Re-balances Electrolytes and ACID/BASE
+ Improves Neuropathy r/t uremia
---- CAN'T FIX:
- ANEMIA
- BP disturbances
- Bone Disease
- Can't replace normal kidney function |
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Term
| Infants need _________ calories and fluids than adults. |
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Definition
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Term
| Newborns have a ______ proportion of water, ECF, turnover and loss than adults. |
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Definition
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Term
| In infants I&O's are _______ bc they are so fragile. |
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Definition
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Term
| Infants are _______ to increase renal output |
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Definition
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Term
| What does it mean if an infant is crying and shedding no tears? |
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Definition
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