| A | B |
|---|
| Acute Renal Failure (ARF) is reversible | Yes, up to a point |
| Three types of Acute Renal Failure (ARF) | Pre-renal (before kidney), intrarenal (also called intrinsic), post (after kidney) |
| Typical causes of Acute Renal Failure (ARF) | Trauma, shock, sepsis (SIRS from inflammation section + infection) |
| Manifestations of Acute Renal Failure (ARF) | Azotemia, decreased GFR, electrolyte imbalances, metabolic acidosis |
| Phases of Acute Renal Failure (ARF) | Oliguric, diuretic and recovery |
| Pre-renal Acute Renal Failure (ARF) cause | Decreased blood flow to kidney (hypoperfusion) |
| Things that can decrease blood flow to kidney | Hemorrhage (loss of lots of blood), dehydration and burns |
| Post-renal Acute Renal Failure (ARF) causes | Obstructions most common is prostatic hyperplasia |
| Intrinsic Acute Renal Failure (ARF) definition | Damage to structures within kidney (glomerulus, tubules, and interstitial areas) |
| Causes of Intrinsic Acute Renal Failure (ARF) | Ischemia (decreased blood flow that's associated with pre-renal), toxic substances (like drugs/ chemicals), acute nephritic syndrome, acute pyleonephritis |
| ATN | Acute tubular necrosis |
| Cells in tubules damaged causing necrosis and sloughing of tubular epithelial cells leads to obstruction (due to cellular debris) this increases the pressure in the tube resulting in decreased GFR | Patho of ATN |
| Ischemic ATN | Decreased blood flow leading to damage to basement membrane. Usually irreversible. |
| Nephrotoxic ATN | Caused by ingestion of toxic substances like antifreeze. Likely reversible. |
| Chronic Kidney Disease (CKD) | Irreversible destruction of the kidney |
| Best indicator of kidney function | GFR. It will be decreased in renal disease. |
| Causes of Chronic Kidney Disease (CKD) | Diabetes Mellitus, hypertension, polycystic kidney disease, glomerulonephritis, ARF (acute renal failure) |
| When do symptoms occur in Chronic Kidney Disease (CKD) | When GFR is < 50% of normal level |
| When will bone issues begin in Chronic Kidney Disease (CKD) | When GFR < 50% of normal. Bone issue are usually the first sign of a problem. |
| When will anemia occur in Chronic Kidney Disease (CKD) | When GFR is 20 - 50% of normal |
| Hypertension, azotemia and proteinuria occur when | GFR is 20 - 50% of normal or a level of 30 - 59 mL/ min |
| GFR < 20% of normal or level of 15 -29 mL/ min | Kidneys cannot regulate fluid and electrolytes, sodium and water retention leading to both edema and hypertension, hyperkalemia, metabolic acidosis |
| GFR < 5- 10 % of normal or level <15 mL/ min | Dialysis is required, anuria (no urine), renal atrophy and fribrosis present |
| Labs values in Chronic Kidney Disease (CKD) | Increased BUN, Increased Creatinine, Increased Phosphate, Increased Potassium. Decreased RBCs, Decreased Hemoglobin and Hematocrit, Decreased Calcium. Patient will also be in metabolic acidosis |
| Why would a patient with Chronic Kidney Disease (CKD) have anemia? | The kidney stimulates production of RBC by releasing erythropoietin |
| Why does a patient with Chronic Kidney Disease (CKD) have a metallic taste? | Secondary to uremia |
| What cardiac problems can Chronic Kidney Disease (CKD) cause? | Hypertension, pulmonary edema, pericarditis, heart disease |
| What effect does the kidney have on vitamin D? | The kidney activates vitamin D which will increase calcium reabsorption from the GI tract. |
