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What are the three processes that the nephron carries out?
- Glomerular fitration
- tubular reabsorption
- tubular secretion
What is the normal GFR?
What is the normal specific gravity for urine?
1.010 - 1.025
What is the normal urine output per hour?
What conditions have high specific gravity?
- SIADH, too much ADH
- Dye injected for surgery
What is specific gravity?
the solute concentration of the urine
What are some examples of decreased specific gravity?
Why does creatinine reflect the GFR?
Because creatine is freely filtered in the glomeruli
What is the normal creatine level?
115 - 125
How could you estimate the functional capacity of the kidneys?
- serum creatinine can give you an estimate of kidney function
- Levels wont show until damage has already been done
Where does the BUN come from?
What will raise the levels of BUN?
- protein digestion
- GI bleeding
What is the normal BUN:creatinine ration?
Is BUN specific to renal failure?
What is the benefit of the kidney injury molecule marker?
It will show kidney damage earlier
What is the function of the kidney?
maintain a stable environment for optimal cell and tissue metabolism
What endocrine functions does the kidney carry out?
- Activate Vit-D
- Secrete erythropoetin
- control of blood pressure- see slide for specifics
- regulate the commonality of the extracellular fluid
Where is ADH secreted from?
the posterior pituitary gland
What are some patho processes related to kidney failure?
- fluid volume excess
- electrolyte and acid base balance abnormalities
- accumulated nitrogenous wastes
- hormonal inadequacies
What is Acute renal failure?
- hours to days - clears up in 3 weeks
- about half of the nephrons not working
- can become chronic
What is chronic renal failure?
- months to years
- 90-95% of nephrons irreversibly damaged
- requires renal replacement therapy
What is the most common type of ARF
What is the most common type of intrarenal ARF?
What causes ATN?
Direct damage to the tubule will precipitate in downstream obstruction causes pressure to build in the tubule. The pressure can cause damage to the tubule and necrosis follows
What are the three phases of ATN?
- Maintenance phase
- recovery phase
What is the treatment for ARF?
- Identify and treat the underlying process
- Minimizing infection
- proper nutrition
- fluid restriction
What is CKD?
- permanent loss of nephrons
- GFR less than 60 ml/min for three months or longer
What are the five stages of CKD see slide
See slide # 23 for manifestations of CKD
What is nephrotic syndrome?
An increased in glomerular permeability that results in a loss of plasma proteins in the urine
What are some characteristics of Nephrotic syndrome?
- generalized edema
What is Glomerular nephritis?
Damage caused by antigen antibody complexes, causes direct golmerular injury
What are some common characteristics of acute GN?
- Group A poststreptococcol
- 7-10 days throut, skin infection
- 10-21 days following infection
- - hematuria, protienura, see the slide
What are some common characteristics of Chronic GN?
What is the treatment of CKD?
- Should compliment the original precipitating event
- -lower BP
- -stop smoking
- treat urinary tract infections
What are the advantages of hemodialysis?
- More efficient
- shorter time needed
What are some disadvantages of hemodialysis?
- Disequalibrium syndrome
- muscle cramps
- air embolus
- hemodynamic instability
What are some advantages of perotineal dyalisis?
- Easy access
- Few hemodynamic complications
What are the complications of PD?
- Protein loss
- respiratory distress
- bowel perf
What is Hyperacute rejection?
onset within 48 hrs
What are the clinical manifestations of hyperacute rejections?
What is the treatment of Hyperacute rejections?
immediate removal of transplanted kidney.
What is acute re
rejection occuring during the first sveral months
What are the clinical manifestations of acute
- oliguria or anuria
- increased temperature
- increased BP
- elarged, tender kidney
What is chronic rejection?
Occurs over months to years
What is spastic bladder dysfuntion?
What is the most common type of renal CA?
renal cell carcinoma
What is a manifestation of bladder carcinoma?
What do we call lower UTI?
What do we call upper UTI?
What does obstruction cause?