10.27: intro

Question 1

Major functions of the kidney?

Answer 1

1. Filtration
2. Excretion
3. Electrolyte / acid base homeostasis
4. BP regulation

Question 2

When are GFR calculations reliable?

Answer 2

• Only when ptn. is in steady state

- Calculations do not work once patient has renal impairment

Question 3

Equation for fractional excretion of Na / urea?

Answer 3

= (Urine Na / Plasma Na) / (Urine Creatinine / Plasma Ca)

***Helps to determine cause of acute kidney injury

Question 4

Components of the kidney?

Answer 4

1. Glomeruli
2. Tubules
3. Interstitium
4. Vasculature
5. Renal calyx

Question 5

Components of collecting system?

Answer 5

1. Ureters
2. Bladder
3. Urethra

Question 6

GFR equation?

Answer 6

(Urine creatinine x volume) / Plasma creatinine

Question 7

Cockrost Gault GFR forluma?

Answer 7

( (140 - age) x weight (kg) x .85 (females)) / 72 x serum Cr

Question 8

What is normal urine output?

Answer 8

1500 ml per day

Question 9

What is Oliguria?

Answer 9

• Too little urine output

Question 10

What is anuria?

Answer 10

No urine output

Question 11

What is polyuria?

Answer 11

• > 3000 ml per day

- Too much urine output

Question 12

What is azotemia?

Answer 12

• An elevation in renal indices

- Normally an increase in BUN

Question 13

What is BUN?

Answer 13

“Blood urea nitrogen”

- Urea nitrogen is formed when protein breaks down

Question 14

What is uremia?

Answer 14

• Syndrome that can accompany severe renal failure
  1. Fatigue
  2. Anorexia
  3. Altered mental status
  4. Serositis: effusion
  5. Platelet dysfunction
  6. Itching

Question 15

What is AKI? ARF?

Answer 15

ARF: “Acute renal failure” old term
AKI: “Acute kidney injury” new term

Question 16

What are CRI? CRF? CKD?

Answer 16

CRI: “Chronic renal insufficiency”
CRF: “Chronic renal failure”
CKD: “Chronic kidney disease” NEW TERM

Question 17

What is ESRD?

Answer 17

• “End stage renal disease”

Question 18

Parameters for AKI?

Answer 18

Abrupt drop in kidney function in 48 hours defined as:

1. Increase serum Cr
2. Oliguria

Question 19

Characteristics of CKD?

Answer 19

• Progressive decrease in GFR over time
• Usually lasting at least 3 months
• With or without albuminuria

Question 20

What is normal GFR?

Answer 20

> 90

Question 21

What are the 5 stages of renal disease?

Answer 21

1. Kidney damage with normal GFR > 90
2. Kidney damage with GFR 60 - 89
3. GFR 30 - 59
4. GFR 15 - 29
5. Kidney failure: GFR

Question 22

What is hematuria?

Answer 22

Blood in the urine

Question 23

What is nephrolithiasis?

Answer 23

• AKA “Kidney Stones”
• Presents as moderate to severe renal colic
• Ca oxalate and Ca phosphate most common

Question 24

Another name for kidney stones?

Answer 24

Nephrolithiasis

Question 25

What are dysmorphic RBCs in urine characteristic of?

Answer 25

- Glomerular hematuria

Question 26

What is pyuria?

Answer 26

WBCs or pus in the urine

Question 27

When are epithelial casts usually seen?

Answer 27

Acute tubular necrosis

Question 28

When are fatty casts seen?

Answer 28

Lipiduria seen in nephrotic syndrome

Question 29

When are hyaline casts seen?

Answer 29

1. Dehydration 2. Exercise 3. Diuretic therapy

Question 30

When are waxy casts seen?

Answer 30

Advanced kidney disease

Question 31

What is nephrotic syndrome? Characteristics?

Answer 31

* * > 3 - 3.5g / day of protein in urine 1. Hypoalbuminemia 2. Peripheral edema 3. Hyperlipidemia: to raise oncotic pressure 4. Thrombophilia: tendency to clot, in renal vein 5. Bland urinary sediment 6. Non inflammatory renal biopsy

Question 32

Characteristics of nephritic syndrome?

Answer 32

1. Inflammatory renal biopsy 2. Active urinary sediment 3. Variable proteinuria 4. Azotemia / oliguria 5. Mild Htn.

Question 33

What is normal total body water?

Answer 33

- 60% total body weight - 2/3 intracellular, 1/3 extra - 1/4 of extra is plasma volume - 3/4 extra is interstitial space

Question 34

What are IV crystalloid solutions?

Answer 34

- Used in volume depletion | - Disperse across ECW

Question 35

What are IV colloid solutions?

Answer 35

- Given in volume depletion - Tend to stay in plasma volume - Packed RBCs or albumin solution

Question 36

Where is EPO produced?

Answer 36

Kidneys

Question 37

Function of Vitamin D?

Answer 37

- Regulates Ca absorption and maintains normal levels of Ca and phosphorus

Question 38

Where is vitamin D activated?

Answer 38

- In the kidneys | - Produced in liver

Question 39

Why is anemia seen in advanced kidney disease?

Answer 39

EPO is made in kidney

Question 40

Why is there decrease in vitamin D in kidney disease?

Answer 40

- Vitamin D is activated in kidney

Question 41

What are the non specific symptoms of renal disease?

Answer 41

1. Fever 2. Pain 3. Rash 4. Eosinophilia

Question 42

What type of molecules can be

Answer 42

- Small, uncharged un protein bound molecules