Renal PKD.txt

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Renal PKD.txt
2013-09-14 18:07:30
Renal PKD

Renal PKD
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  1. Polycystic kidney disease
    inherited disorder in which fluid filled cysts develop in the nephrons
  2. Patients with polycystic kidney disease have
    HTN related to ischemia from the enlarging cysts; as the vessels are compressed and blood flow to kidneys decreases, the renin-angiotensin system is activated raising BP
  3. Cerebral aneurysms are
    higher in patients with
  4. Recessive form of PKD
    die in early childhood
  5. Most common form of polycystic disease
  6. What percentage of family members inherit the disease
  7. Nearly what percent of people with ADPKD will develop cysts by at 30
  8. Can PKD be prevented?
    No but early detection can help, genetic counseling
  9. Pathophys
    cysts develop in the nephron, cysts become bigger, as cysts fill with fluid and enlarge the nephron and kidney become less effective; may enlarge to 2-3 times normal kidney size and may weigh 10 lbs
  10. What other medical problems can PKD patients have
    heart valve, left ventricular hypertrophy, colonic diverticuli
  11. Features of PKD
    abdominal or flank pain, HTN, nocturia, increased ABD girth, constipation, bloody or cloudy urine, kidney stone
  12. Assessment for PKD
    family history
  13. As kidney function declines
    serum creatinine and BUN rise and creatinine clearance decreases
  14. Interventions for PKD
    pain mgmt., infection prevention, constipation, HTN, and chronic kidney disease
  15. Pain
    cautiously use NSAIDS, antibiotic therapy can be nephrotoxic; dry heat to ABD or flank, cysts can be removed by aspiration and drainage but usually refill
  16. Prevent constipation
    adequate fluid intake, increasing dietary fiber when fluid is more than 2500 ml and exercising regularly; stool softeners and bulk agents; this is because large intestine is getting smushed
  17. Controlling HTN and preventing CKD
    2L of fluid a day to prevent dehydration, low sodium
  18. Meds for renal
    ACE inhibitors may help control the cell growth aspects of PKD and recude microalbuminuria
  19. Patient self education
    measure and record BP, take temp if you think you have a fever, weigh every day at same time and let provider know if sudden weight gain, limit salt, tell if foul smelling or blood in urine, headache or visual disturbances, monitor bowel movements