Quiz #11 Diseases of the Renal System

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Primary causes of chronic kidney disease

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Primary causes of chronic kidney disease

-Maintenance of homeostasis through control of fluid, p H, electrolyte balance, and blood pressure
-Excretion of metabolic end products and foreign substances
-Production of enzymes and hormones

The Kidneys: Pathophysiology Overview

Signs and symptoms:
-Hypertension: sodium retention and edema lead to an increase in blood pressure
-Edema
-Metabolic acidosis: as a result of the kidneys' decreased ability to excrete hydrogen ions
-Anemia: due to the kidneys inability to make adequate erythropoietin, the hormone that stimulates the production of red blood cells.
-Uremia: a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys
-Hyperkalemia
-Microcytic anemia and iron deficiency
-Azotemia: elevation of blood urea nitrogen (BUN) and serum creatinine levels
-Secondary hyperparathyroidism
-Renal osteodystrophy

Chronic Kidney Disease (C K D)

Syndrome in which progressive loss of kidney function occurs
-Irreversible
-Five stages
-Progression to C K D stage 5 results in uremia and requires initiation of renal replacement therapy (R R T)

Laboratory Evaluation of Kidney Function

Urinalysis
-Microalbuminuria (low levels of urinary albumin excretion of 30 to 300 mg/d)
-Often one of the first signs of renal insufficiency
Clearance tests
-Rate at which substances are cleared from plasma
-Measure glomerular filtration rate (G F R)
-The normal GFR is approximately 135-200 L/day (~120 mL/minute). Of this large volume, 98%-99% of the filtrate is reabsorbed, with urine output usually averaging 1-2 L/day. The GFR is used to evaluate kidney health, estimate the severity of diagnosed disease, and monitor kidney disease progression.
Serum creatinine levels start to increase as kidney function decreases.