Term
| physiological functions of the kidney |
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Definition
| excretion, filtration, secretion, electolyte and acid/ base balance, blood volume control, detox and endocrine |
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Term
| endocrine function of kidney |
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Definition
| erythropoetin (increases RBC production) and calcitriol (vit D) |
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Term
| kidney as a target of toxicity |
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Definition
| receives high cardiac output and substances are filtered into urine and LARGE amounts of drugs/toxins are held in a SMALL volumes |
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Term
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Definition
| some drugs and prodrugs are broken down in the liver AND kidney, these metabolites might be toxic |
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Term
| risk factors for kidney toxicity |
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Definition
| age, diabetes, heart failure or other factors that cause decreased profusion, and decreased ability to filter |
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Term
| hemodynamic renal failure (pre-renal) |
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Definition
| decreased renal profusion by either prolonged vasoconstriction or HYPOtn/ shock or hemorrhage that decrease renal blood flow/ decreased BP causing ISCHEMIA |
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Term
| ACE/ ARB and cyclooxygenase inhibitors (ibuprofen/ aspirin) |
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Definition
| hemodynamic renal failure |
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Term
| hemodynamic renal failure: ACE/ ARB |
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Definition
| increased vasodilation, decreasing profusion and glomerular filtration rate causing ISCHEMIA |
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Term
| hemodynamic renal failure: Ibuprofen/ aspirin |
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Definition
| inhibits cyclooxygenase and production of prostaglandins to decrease renin facilitation of secretion of renin, decrease profusion and causing ISCHEMIA |
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Term
| Patient at risk for hemodynamic renal failure: Ibuprofen/ aspirin |
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Definition
| boderline renal function, renal arterial stenosis, hypovolemia, sepsis, severe chronic heart failure and kidney disease |
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Term
| Acute intersticial nephritis (intrinsic) |
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Definition
| inflammation of renal tubules and intersticial tissue between glomerulus and tubules |
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Term
| NSAIDs, APAP and Beta-lactams |
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Definition
| acute intersticial nephritis |
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Term
| Acute tubular necrosis (intrinsic) |
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Definition
| either ischemic tubular necrosis where there is decreased profusion/ ISCHEMIA (which is caused by drugs) or direct damage from drugs/ toxins in proximal tubules; excess free radicals, local vasoconstriction and altered cell permeability |
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Term
| Aminoglycosides, amphiteracin B and NSAIDs |
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Definition
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Term
| acute tubular necrosis: aminoglycosides (gentamycin, kenamycin) |
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Definition
| bind to phospholipids in mitochondria and lysosomal membranes in proxymal tubules generating ROS |
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Term
| acute tubular necrosis: amphoteracin B |
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Definition
| in patients with accumulative dose of 3-4 g in lifetime, affecting proximal and distal tubules increasing permeability, increased oxygen requirements and causing vasioconstriction |
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Term
| contraindication of amphoteracin B |
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Definition
| Carbicillin and ticarcillin; due to additive nephrotoxicity |
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Term
| glomerular nephritis(intrisic) |
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Definition
| possibly temporary but can progress and destroy glomerulus leading to chronic renal failure and end stage renal disease |
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Term
| glomerular nephritis: minimal change disease (MCD) |
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Definition
| most common in pediactrics, looks normal but function is impaired |
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Term
| minimal change disease (MCD) |
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Definition
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Term
| glomerular nephritis: focal segmental glomerulosclerosis |
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Definition
| recognizable scarring that is segmental not bilateral and usually unilateral |
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Term
| focal segmental glomerulosclerosis |
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Definition
| Heroin and Opioid addicts |
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Term
| glomerular nephritis: thin basement membrane nephropathy |
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Definition
| thinning of basement membrane common cause of asymptomatic hematuria (blood in urine), it is observational, not a functional problem |
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Term
| thin basement membrane nephropathy |
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Definition
| NSAIDs, mercury, penicillamine, gold therapy |
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Term
| glomerular nephritis: membraneproliferative glomerulonephritis |
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Definition
| immune material diposits in glomerulus from intraglomerular magnesium |
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Term
| membraneproliferative glomerulonephritis |
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Definition
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Term
| obstructive neuropathy (post-renal) |
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Definition
| renal dysfunction caused by structural/ functional hindrance to normal urine flow |
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Term
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Definition
| urate crystallization where crystals deposit in ureters, occurs in cancer patients |
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Term
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Definition
| Urate nephropaty, stones produced due to cell breakdown and purine/ pyrimadine liberation and ultimate conversion by xanthine oxidase to uric acid which forms stones |
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Term
| drug-induced crystalluria |
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Definition
| presence and excretion of insoluble metabolites of drugs that precipitate and crystallize |
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Term
| retroperitoneal fibrosis (psot-renal) |
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Definition
| fibrous tissue mesh that forms between back end of peritoneal cavity and kidney/ ureters |
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Term
| methotrexate, ergot derivatives (methysergide, ergotamine) |
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Definition
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