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what is the unit of kidney structure and function?
main functions of the kidneys?
- -maintain fluid balance
- -renin mechanism major control over blood pressure
- -erythropitin is critical determinant of RBC activity in bone marrow
- -kidney necessary to produce active form of vitamin D
what is creatinine?
- waste product of muscle metabolism
- produced by muscles
- determine lean body mass
How is creatinine excreted?
excreted into urine by kidneys
How does the body catabolize the nitrogen group of amino acids?
breakdown of nitrogen into ammonia by the liver -> urea cycle -> urea to blood -> excreted by kidneys
what is the active form of vitamin D and where is it activated?
- active form: 1,25-dihydroxy vitamin D3
seperation of molecules in solution by diffusion through selectively permeable membrane on the basis of molecule size and concentraion gradient?
the 24-hour urinary excretion of _________ is proportionate to the skeletal muscle mass of the individual.
foods rich in phosphrous?
foods renal patients can have?
what is the accumulation of excess body fluids in cells, tissues causing swelling
________ is the most abundant intracellular cation
why is high blood potassium considered dangerous?
causes stress on the heart = heart attack
fluid needs of healthy adults ?
1 mL/per kcal of energy in the diet per day
_______ is the branch of medicine studying kidney, anatomy, physiology, and pathology
_______ are spcialists of the kidneys, their diseases and medical management
_______ is the general term referring to an abnormal condition of the kidneys due to disease?
_________ is kidney inflammation, which can be acute and chronic
_______ is when renal tissue is hardened due to blood flow, often caused by hypertension?
____________ is abnormal kidney condition causing clinical signs of edema, marked proteinuria, low blood albumin due to increased glomerular permeability as a result of glomerular injury
-peeing out protein
-lose 6-8g of protein a day
_________ is a clinical state of severe glomerulonephritis with blood in urine, high blood pressure and kidney failure
_________ qualifies a state of excess urea in blood
___________ is abnormally high amount of protein in urine
___________ is the abnormal presence of albumin in the urine
________ is the abnormal presence of blood in the urine
__________ means high blood sodium concentration
_________ means high blood potassium concentration
what is CKD
chronic kidney disease
what is ESRD
end stage renal disease
what does BUN mean?
blood urea nitrogen
what does GFR stand for?
glomeruler filtration rate
what does HBV mean?
high biological value
kidneys are responsible for maintaining blood pH at?
which clients are susceptible to develop acute renal failure?
intensive care clients
what are metabolic abnormalities seen in clients with acute renal failure?
- reduced urine production
type of diet recommended for clients with acute renal failure
- increase energy
- water-soluble vitamin supplement
- restrict pot. sod, fluids
what factors to keep in mind when making nutritional recommendations for clients with acute renal failure?
- nutrition status
- renal function
5 stages of developement of chronic kidney disease
- 1. damage to kidneys
- 2.damage progresses
- 3.GFR mod decrease 30-59
- 4. GFR below 30
- 5. GFR below 15, end stage
what are metabolic and clinical consequences of chronic kidney failure?
- less able to perform:
- cant remove waste
- cant remove protein
- increase blood to toxic levels
what are the symptoms caused by increased levels of urea in the blood or uremic symptoms?
what are the two main goals of MNT for clients with pre-ESRD (stages 1-4)
- meet nutritional needs
- provide nutrition education
type of diet for pre-ESRD
- pro- .6-.8
- energy- 35-40
- reduce: pro, pho, sod
protein intake for pre-ESRD
what amount of energy recommended for clients with pre-ESRD
what amount of phosphorus recommended for clients with pre-ESRD
what amount of sodium recommended for clients with pre-ESRD
what amount of potassium recommended for clients with pre-ESRD
what amount of calcium recommended for clients with pre-ESRD
when glomeruler filtration rate falls below 20ml of blood per minutes, blood _______ concentration increases
when blood phosphorus concentration increases it inhibits vitamin ___ activation by kidneys
Inhibitation of vit. D reduces absorbtion of dietary______ leading to low blood calcium
the brain reacts by stimulating the secretion of _______ hormone, which increases blood calcium concentration
number one way to prevent renal osteodystrophy in clients with chronic renal insuffiency is to control blood ______ concentration
this medication can help control blood phosphorus
vitamin ___ supplementation is associated with toxicity in patients with chronic renal insufficency
what are the goals of MNT for clients with nephrotic syndrome who are not on dialysis?
- assist with nutritional needs
- reduce metabolic complications
- slow progression
kidneys are important for activation of vitamin ___?
what is the main waste product of amino acids catabolism?
the two main causes of chronic kidney disease are?
hypertension and diabetes
who will have a higher plasma creatinine concentration young male or old woman?
young man due to more muscle
what is the creatinine height index?
measures muscle based on young age, creatinine
do high protein diets cause chronic renal failure?
no, renal failure disease should not be on high protein (.8-1g)
renal clients suffering from fluid restrictions is suffering from
thirst what to do?
- swish water
- hard candie
- sice cubes
- smaller glass
- drink slow
- lemon juice
a low protein-phosphorus diet is recommended for clients with
pre-ESRD for the following reasons?
prevent waste products, calcium waste, nitrogenous waste
these foods are high in potassium?
melons, seeds, bananas, baked potatoes
these foods are high in phosphorus?
liver, baked beans, chocolate, nuts
in a catabolic client, cell breakdown releases ______ which
increases in blood
high serum ______ concentration makes clients feel itchy and causes muscle spasms?
low serum _____ concentration is the biggest predictor of
morbidity and morality in clients with renal disease?
which abnormal biochemical test values are typically seen in
clients with nephrotic syndrome?
- low albumin
- increase blood lipids
- protein in urine
in clients using continuous ambulatory peritoneal dialysis the
_____ ______ serves as a natural dialyzing membrane
Dietary recommendations for pre-ESRD?
- protein: .6-.8g
- sodium: 1-3g
dietary recommendations for nephrotic syndrome?
- fat: <30%
- sodium: 1-3g
dietary recommendations for ESRD with hemodialysis?
- sodium: 3-4g
- fluid:500mL + urine output
ESRD with peritoneal dialysis?
- sodium: 2-4g
- fluid: 2000mL
dietary recommendations for acute renal failure?
- protein: .6-.8g
- energy: 30-35kcal
- phosphorus: restrict
- sodium: restrict
- potassium: restrict
less than 500ml urine/day
accumulation of nitrogen containing waste products in blood
ablilty to eliminate nitrgenous waste products
inablilty to excrete the daily load of wastes
MNT for ESRD
equation for GFR?
creatinine + urea /2 = GFR
How to slow the process of chronic kidney disease?
- control blood sugar levels
- control blood pressure
- losing excess wt
what is peritoneal dialysis?
lining of patients pertinoneal wall is the selective membrane
what is hemodiaylsis?
membrane is manmade diaylzer
when it comes to monitoring the body of someone with renal disease
sodium is up =
blood pressure up=
blood pressure down=
- lots of water on board
- retaining water
mEq x39 =
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