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nutrition chapter 22 study guide

Terms in this set (46)

what do the glomerulus and bowman's capsule do
glomerulus - filters (forms filtrate)

bowmans capsule - holds glomerulus, covers it like sieve, stops blood cells and plasma proteins from entering
kidneys filter blood and form urine and maintain what kind of balance
acid-base balance
nephrotic syndrome
characterized by massive proteinuria caused by glomerular damage.
proteinuria
the presence of an abnormal amount of protein in the urine
causes of nephrotic syndrome
-glomerular damage
-infections
-chemical damage
-diabetic nephropathy
hypoalbuminemia and its relation to edema
hypoalbuminemia - low plasma albumin concentration

because albumin helps maintain fluid balances. low albumin concentration contributes to edemas
what happens when there is a loss of vitamin D levels with nephrotic syndrome
results in lower vitamin D & calcium levels & increase in rickets disease in children
should a patient with nephrotic syndrome be on a high protein diet
no because they will lose a lot of that protein in urine
protein and energy needs per kilo of body weight
0.8 to 1g per kg of body weight protein

35kcal per kg of body weight
what does controlling sodium do in nephrotic syndrome
helps combat edema
what should sodium be restricted to with nephrotic syndrome
1000-2000mg per day
causes of acute kidney injury are
-critical illness, sepsis, or major surgery
how are kidney injury classified
prerenal - blood flow to kidney
intrarenal - damage to kidney
postrenal - urine
prerenal factors that cause acute kidney disease
-low blood volume or pressure
-renal artery disorders
-heart disorders
oliguria
low urine output
anuria
absence of urine
abnormal lab results that indicate oliguria are
-rise in serum creatine levels
-elevate blood urea nitrogen
fluid and electrolyte imbalance can lead to what
hyperkalemia - elevated serum potassium levels (heart failure)

hyperphosphatemia - elevated phosphate levels (loss of bone calcium)
uremia
presence of urinary waste in the blood caused by impaired kidney function
diuresis
increased formation and secretion of urine. also signals recovery from kidney injury
what medication is provided to patient with edema
diuretics; furosemide (lasix)
If patients with acute kidney injury cannot tolerate enteral nutrition, what is the option
parenteral
common causes of chronic kidney disease
diabetes mellitus & hypertension

-both of these impair function of arteries surrounding kidneys
how is chronic kidney disease evaluated
glomerular filtration rate
- rate of filtrate formed by kidneys
- amount of albumin lost in urine
clinical effects of chronic kidney disease
early stage
-anorexia
-fatigue
-headache
-hypertension

advanced stage
-anemia
-cardiovascular disease
-confusion
-electrolyte imbalances
-fluid retention
-wasting
-nasuea
kidney failure stages and GFR
stage 1: kidney damage with normal or increased gfr >90

stage 2: mildly decreased GFR 60-89

stage 3a: mild to moderately decreased GFR 45-59

stage 3b: moderately to severely decreased GFR 30-44

stage 4: severely decreased GFR 15-29

stage 5: kidney failure under 15
what hormone prevents renal osteodystrophy
parathyroid hormone
uremic syndrome - what clinical affects can they produce
- abnormally high levels of waste in the blood
- caused by glomerulus not filtering properly
treatment goals of chronic kidney disease
-slow disease progression
-prevent or alleviate complications
-prevent wasting
energy needs are to maintain what in chronic kidney disease
healthy body weight
protein intake for 3 dialysis
-predialysis (lowest)
0.6-0.7
-hemodialysis
1.2
-peritoneal dialysis (highest)
1.2-1.3
how does a low protein diet affect chronic kidney disease
-supply less phosphorus
-reduce risk of hyperphospatemia
are sodium and fluid restriction recommended for CKD
-most patients may retain sodium so they may benefit from a restriction
-fluid are not restricted until urine output decreases
Foods high in potassium
• Avocado
• Bananas
• Cantaloupe
• Carrots
• Fish
• Mushrooms
• Oranges
• Potatoes
• Pork, Beef, Veal
• Raisins
• Spinach
• Strawberries
• Tomatoes
Foods high in phosphorus
Milk, liver, legumes, fish, and soy
hypercalcemia
an abnormally high level of calcium in the blood
should vitamin c supplementation be limited
yes because it can contribute to kidney stones
if iron is low how should it be supplemented
intravenous administration
what % of patients receive a transplant
20%
How do kidney stones form?
stone constituents become conentrated in urine
hypercalciuria
elevated calcium in the urine
What are uric acid stones?
-uric acid stones, are stones that develop when the urine is very acidic
-associated with gout
best way to prevent kidney stones
drinking lots of fluids (Except soft drinks)
renal colic
stones passing through ureter
urinary tract complication
stone that are unable to pass
how much water should patient with kidney stone drink
12 cups of fluid daily
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