List the many roles of the kidneys
- Waste Elimination
- Control Blood pressure; releases Renin
- Regulate RBC Production; releases erithopetin
- Break down drugs
- Glucose homeostasis
- Metabolize hormones
- Vit D synthesis and calcium balance; inactive when kidney doesn’t function properly
- Manage Electrolyte
- Balance pH of the bloodstream
Renal function is dependent on
renal perfusion
- no perfusion, no function
The amount of blood being filtered by the kidneys is the
Gloumeral Filtration Rate(GFR)
Two main reasons that our kidneys are at risk for injury
- exposed to many toxins( nephrotoxins)
- Susceptible to ischemic injury; need lots of blood flow
Three categories of kidney disfunction
prerenal, intrarenal, postrenal
Prerenal dysfunction
- before the kidneys
- issues before it reaches kidney
- not perfusing well
Intrarenal dysfunction
- inside the kidney
- injury to kidney itself
Postrenal dysfunction
- outside/ after the kidney
- before going out of the body
- obstruction
Most reliable indicator of kidney disfunction
Serum Creatinine
3 types of dialysis
Hemodialysis, peritoneal, continuous renal replacement therapy (crrt)
Prerenal potential causes of injury
- cardiac dysfunction; ^HR, CHF
- shock, not perfusing blood well
Intrarenal potential causes of injury
- toxic medications(NSAIDS)
- any infection processes
Postrenal potential causes of injury
- BPH
- Tumors
- Bladder issues
- Kidney stones
Four phases of AKI
- Initial
- Oliguria
- Diuresis
- Recovery
Most important thing to remember related to AKI Treatment
TREAT THE CAUSE!
Nephron
Basic unit of the kidney
Glomerular Filtration Rate
- Amount of blood being filtered by the kidneys
- per minute
- normal 90-120 ml/min
Initial phase; AKI
- lasts hours to days
- time from the precipitating insult(injury) until the time of initial manifestations
Oliguria phase; AKI
- significant decrease in GFR, urine output
- retention of fluid, urea, potassium, sulfate, and creatine
- inflammation begins to occur in the nephrons
Diuresis phase; AKI
- kidneys are beginning to recover from initial injury
- increased urine output, might be “dumb” urine
- can take up to months
Recovery Phase; AKI
- time needed for final repair of renal damage(months)
- starts with onset of increased urine output
- renal function returns to normal, urine is appropriately concentrated
Hydronephrosis
- fluid in the kidney
- detected with ultrasound
Which of the following signs or symptoms did the nurse educator notice that indicated urospesis
A. presence of leukocytes in the urine
B. burning on urination
C. presence of fever
D. bladder spasms
C.
Presence of fever
Nephrolithiasis is another name for
Kidney stones
