Renal

Question 1

What is the main function of the kidneys?

Answer 1

Entire blood supply circulates 12 times a day

-filter out waste products

Question 2

How much urine does the bladder typically hold?

• What are the risks for a person that holds urine?

Answer 2

400-500 cc

Risk for infection if person holds urine.

Question 3

What are the functions of the kidneys?

Answer 3

Water balance

Electrolyte regulation

Synthesis of Vit D

Regulation of RBC production

Question 4

What further issues do patients with kidney problems have?

Answer 4

Difficulty storing calcium due to vitamin D synthesis issues.

Question 5

What is:

• Osmolarity
• Osmolality

Answer 5

• Osmolarity= Ratio of solutes to water
• Osmolality= Dilution of urine

Question 6

What are the functions of aldosterone?

Answer 6

• Reabsorbs sodium
• Causes secretion of potassium

Question 7

What are the two types of natriuretic peptides?

Where are they secreted?

Answer 7

• ANP
  
  • Secreted by heart cells in atria with increase of pressure in atria
• BNP
  
  • Secreted by heart cells in ventricles with increased ventricular pressure

Question 8

What do natriuretic peptides do?

Answer 8

Inhibit sodium and water from being absorbed.

Question 9

Where is vitamin D received?

What is its main purpose?

Answer 9

Obtained in diet/synthesized by sun exposure

Aids in absorption of calcium/potassium

Question 10

What is erythropoietin?

When is it made?

Answer 10

Stimulates bone marrow to produce RBC

Made with tissue hypoxia

Question 11

How can renal function be deteced in a blood test?

Answer 11

• High creatinine leves indicate kidney failure
  
  • (normal= 0.6-1.2)
• High BUN (blood urea nitrogen)
  
  • (normal= 10-20)

Question 12

What items should not be in urine and indicate kidney function failure?

Answer 12

• Glucose
• Ketones
• Albumin/protein

Question 13

What main test detects creatinine in blood and urine?

What does it indicate?

Answer 13

Glomelular filtration rate= indicates specific kidney filtration function

Question 14

What considerations should be made for aging adults?

Answer 14

• Nephrons die (kidney function slows/declines)

Question 15

What are urinary tract obstructions?

Answer 15

Block that interferes with urine flow in any site of urinary tract.

Question 16

What are Kidney stones (calculi)?

What are the risk factors?

Answer 16

Formation of mineral buildup in kidneys

Risks

• ]Fluid and diet (high calcium, high sodium)
• Men
• Low fluid intake

Question 17

What are the main types of kidney stones?

What causes them?

Answer 17

Calcium oxalate or calcium phosphate (most common)

• Immobilization
• Hyperparathyroidism (Calcitonin increase)

Question 18

What are struvite stones made of?

What are the main characteristics of these stones?

Answer 18

Magnesium/ammonium

• Usually very large

Question 19

What are the main treatments for kidney stones?

Answer 19

• Lithrotripsy (soundwaves breakup stones)
• Increase fluid intake
• Decrease mineral containing foods

Question 20

What is a neurogenic bladder?

What usually causes it?

Answer 20

Bladder issues caused by a neurologic problem.

• associated with spinal cord injury/lesions in sacral spinal cord.

Question 21

What is overactive bladder syndrome (OBS)?

What are the symptoms?

Answer 21

Involuntary bladder contraction during bladder filling that results in incomplete urine emptying/urine retention.

• Frequency, urgency, nocturia

Question 22

What are postvoid urine evaluations?

Answer 22

After voiding, scan bladder to look for retaining of urine.

Question 23

What is a common sign of renal adenoma (cancer) and bladder cancer?

Answer 23

Painless hematuria (blood in urine)

Question 24

What are urinary tract infections (UTI)?

What is the most common cause?

Answer 24

Inflammation of urinary epithelium caused by bacteria?

Usually caused by E coli

Question 25

What is acute cystitis? What are the common symptoms?

Answer 25

UTI of the **bladder** * Frequency * Dysuria (painful urination) * Hematuria

Question 26

What is interstitial cystitis? What are the symptoms?

Answer 26

Inflamed bladder **not due** to bacteria * Small urine volume * Pelvic pain * Frequency

Question 27

What are the treatmens for interstitial cystitis?

Answer 27

No treament; symptom relief

Question 28

**_Pyelonephritis_** What is ti?

Answer 28

Infection of upper urinary tracts (ureters, renal pelvis)

Question 29

_Acute Pyelonephritis_ What is it caused by? What is a common symptom?

Answer 29

Ascending uropathic microorganisms along ureters, * Pain in lower back (CVA tenderness)

Question 30

**_Chronic Pyelonephritis_** What physical alterations are made to kidneys?

Answer 30

* Scarring of kidneys * Increased risk for for infections.

Question 31

What is **glomerulonephritis**? What are the symptoms?

Answer 31

Infection of glomerulus that causes: * Acute kidney failure * Oliguria (\<30 mL/hr) * High blood pressure * Proteinuria (protein in urine)

Question 32

What does **nephrotic syndrome** caused by glomerulonephritis?

Answer 32

* Huge amounts protein in urine * Low protein in blood * Small amounts of hematuria (microscopic)

Question 33

What are the symptoms of **nephritic syndrome** caused by glomerulonephritis?

Answer 33

* **High** amounts of hematuria * Lower amounts of proteinuria (still abnormal) * Azotemia (waste products in blood) *

Question 34

What are the most common causes of glomerulonephritis?

Answer 34

* Group A strep infections * Impetigo * Viral infections (sometimes)

Question 35

What are these results of **acute kidney injury:** * Renal insufficiency * Renal failure * End Stage renal failure

Answer 35

* Renal insufficiency= working but not fully * Renal failure= Signifincant loss of renal function (dialysis) * End Stage renal failure= Renal function \<10%

Question 36

What are the common signs of renal insufficiencies/renal failure?

Answer 36

* Uremia and azotemia (waste products in blood) * Higher creatinine/BUN

Question 37

What are these causes of acute renal failure: * Prerenal

Answer 37

_Most common cause of AKI_ Severe drop in blood pressure or Drop in blood flow to kidneys

Question 38

What is this cause of acute renal failure: * Intrarenal

Answer 38

Direct damage to kidneys (infection, drugs)

Question 39

What is this cause of acute renal failure: * Postrenal

Answer 39

Obstruction of urine flow (prostate, stones)

Question 40

What is chronic kidney disease? What is acute kidney disease?

Answer 40

**Chronic= Progressive** loss of kidney function that **affects all organs** Acute= **sudden** decline in kidney function (drugs, bloodloss)

Question 41

What occurs with water and electrolyte balances with **chronic kidney disease**?

Answer 41

Water retention; edema * Sodium and potassium secretion increases early. * Once oliguria sets in, potassium retained

Question 42

What is hemodialysis? * how often is it performed?

Answer 42

Treatment that uses machine to filter blood when kidney function declines. Received 3-4 hours a week

Question 43

What are these types of hemodialysis: * Arteriovenous fistula * Arteriovenous graft

Answer 43

* Arteriovenous fistula= Surgically connection of artery and vein (longest life) * Arteriovenous graft= Subcutaneous connection of artery and vein using other material.

Question 44

What are the advantages of AV fistula vs AV graft for dialysis?

Answer 44

* AV fistula takes 2-3 months to heal before it can be used * Fistula has a longer life line. * Graft must be used for those with diabetes.

Question 45

What is peritoneal dialysis?

Answer 45

Treatment of hypertension and heart failure using semipermeable peritoneal membrane for dialysis. Takes much longer.