Term
| What is the functional unit of the kidney? |
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Definition
| The nephron (glomerulus + tubules) |
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Term
| What factors affect fluid mvmt through the glomerulus? |
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Definition
| Cap filtration pressure, Colloidal osmotic pressure, cap permeability |
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Term
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Definition
| Change permeability of collecting tubules to H20, allowing increased reabsorption and fluid conservation |
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Term
| Which substances get moved? |
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Definition
| Fluid, E-lytes (Na, K, Cl, Ca, H3PO4), Urea & protein breakdown products, H, Glucose, Amino Acids, Toxins, foreign substances, drugs and their metabolites |
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Term
| Do the kidneys eliminate protein bound drugs? |
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Definition
| Not if the drug is currently bound to a protein |
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Term
| What are some other kidney functions? |
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Definition
| Produce 90% of erythropoietin, activate Vit D |
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Term
| What is the normal urinary output? |
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Definition
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Term
| What does specific gravity measure? |
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Definition
| The concentration of urine; tells osmolality compared to H2O and is usually 1.010-1.025 |
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Term
| What substances in the urine indicate a problem? |
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Definition
| protein, cells, sugar, anything that should normally be reabsorbed |
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Term
| What is the normal level of creatinine? |
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Definition
| 0.6-1.2; it's the byproduct of muscle metabolism |
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Term
| What is the normal BUN level? |
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Definition
| 10-20; byproduct of protein metabolism. high blood levels indicate impaired renal function |
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Term
| How do we look at renal function? |
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Definition
| Radiographic studies; KUB, IVP, CT scan, Sonograph. Biopsy. Cytoscopy. |
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Term
| What are congenital renal disorders? |
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Definition
| Agenesis, Hypoplasia (poorly developed), conjoined kidney (Horse Shoe) |
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Term
| Give me some facts about cystic kidney disease. |
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Definition
| Congenital (most common) and/or acquired; single or multiple, small (common and usually asymptomatic) or large |
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Term
| What is polycystic kidney disease? |
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Definition
| Autosomal Dominant (AKPKD)* systemic affecting liver, heart and other organs * may cause hematuria, UTI, HTN, and renal failure * Tx=symptomatic but dialysis/transplant may be needed for renal failure |
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Term
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Definition
| Very common pediatric cancer. Dx @ 3-4. Tx w/ resection, chemo, radiation. Fairly good success rate |
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Term
| Tell me about adult renal cancer. |
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Definition
| Uncommon. Mostly men. Sometimes associated w/ chronic irritation (stones, tobacco, toxin exposure). Asymptomatic. Tx w/ resection & chemo. Poor survival rate d/t late detection |
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Term
| What are some renal obstructive disorders? |
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Definition
| Congenital anatomical, calculi (stones), tumors, strictures (ureteral, urethral), mechanical blockage (prego, BPH), neurogenic bladder |
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Term
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Definition
| Backflow and increased pressure behind an obstruction. Pre-dispose to UTI d/t stagnation, prolonged may dilate renal pelvis and atrophy the kidney |
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Term
| What is the most common cause of obstruction? |
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Definition
| Calculi! A crystalline stone composed of materials usually excreted by kidney. 70-80% Ca oxalate of Ca Phosphate. Usually form in only 1 kidney. |
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Term
| What are S/S of stones passing and how do we treat it? |
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Definition
| Acute, pain 10/10, n/v, diaphoresis, pale, can't sit still. IV pain meds. Toradol for spasm. Narcotic often required. IV fluids. |
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Term
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Definition
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Term
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Definition
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Term
| What is urosepsis (septicemia)? |
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Definition
| infection of the blood via urinary pathogens |
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Term
| What are predispositions for UTI? |
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Definition
| Female, Anatomic Factors, Disorder of Emptying (obstruction or neurogenic bladder), Intro of bacteria (hygiene, sex, nosocomial), Change in bladder wall (scarring), and Change in mucin layer (soap/bubble bath, estrogen deficient, DM) |
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Term
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Definition
| Frequency, small void amt, pain/burning w/ urination, hesitancy, discolored, foul smelling, hematuria * if ascending abruptly ill, fever, N/V * if prolonged=bladder scarring |
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Term
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Definition
| Bactrim/Sulfa, Quinolones (cipro), pain relief (pyridium), acidification of urine (cran juice, vit c), PREVENT! |
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Term
| What are UTI special considerations? |
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Definition
| Elderly= may show no S/S * Kids=repeat infect may indicate sexual abuse * High Risk=hygiene impaired, DM, indwelling cath |
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Term
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Definition
| hesitancy, urgency, straining/valsalva to void, nocturia, decreased force of stream, post void dribbles |
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Term
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Definition
| Rx= 1) 5 alpha reductase inhib (Proscar)-regression of epithelia prolif. 6-10mo for effect. side effect is decreased ejaculate and libido, gynecomastia. 2) alpa antagonist (Flomax)-relax smooth muscle vasodilate, hypotension. watch out for anti-HTN drugs, ntg and rx for ED. ** Surgical reduction- TURP (Transurethral resect) most common, TUMT (transureth microwave therapy, Transureth needle ablation, Ultrasound, Laser |
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Term
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Definition
| Sildenafil (Viagra)-relax arterial and trabecular smooth muscle. Vardenafil (Levitra) and Tadalafil (Cialis) |
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Term
| What can cause glomerulonephritis (GN)? |
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Definition
| Mostly idiopathic. Damage from HTN & DM. May be acute or chronic. Primary/2ndary to another cause (like strep infection) |
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Term
| Describe proliferative vs membranous GN. |
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Definition
| Prolif= increased swelling and cell overgrowth. Membran=increased thickness of glomerular capillary walls |
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Term
| Describe acute GN that is nephritic vs. nephrotic. |
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Definition
| NEPHRITIC= inflam. post infection (strep). rapidly decline GFR and subsequent oliguria, proteinuria and hematuria. Na and H20 retention causes edema and HTN. NEPHROTIC= idiopathic, 2ndary to DM and SLE. Significant proteinuria and lipuria |
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Term
| What happens with chronic GN? |
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Definition
| Common in elderly. thickening of glomerular basement membrane and sclerotic changes. Reduction in GFR. |
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Term
| How is HTN a cause of kidney disease? |
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Definition
| prolonged HTN increases pressure on glomeruli and causes damage |
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Term
| How is HTN and effect of kidney disease? |
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Definition
| kidney probs affect BP, usually causing HTN |
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Term
| What are some examples of Drugs that, over time, cause kidney damage? |
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Definition
| NSAIDS, Sulfa, excess Vitamin C |
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