Notes in Renal Pathophysiology

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Published	05/06/2024	Renal Review  Most of the nephrons and blood → {{c1::cortex}} Juxtamedullary nephron contain {{c1::vasa recta }}Function – {{c2::c…
Published	05/06/2024	renal functions1. {{c1::Excretion/filtering of blood }}{{c2::endogenous end products of metabolism}} ({{c3::urea}}, {{c3::creatinine}}, {{c3::uri…
Published	05/06/2024	Renal function tests{{c1::Urinalysis}} – strip chem Waste products {{c1::Serum urea (blood urea nitrogen aka BUN) }}{{c1::Serum creatin…
Published	05/06/2024	BUNUrea - {{c1::nontoxic substance made by liver to dispose of ammonia from protein catabolism}}how urea is made -- {{c2::aa → catabolism → ammonia → …
Published	05/06/2024	SCr{{c1::Non-protein waste of creatine phosphate metabolism by skeletal muscle }}Related to {{c1::skeletal muscle mass }}Renal dysfunction →…
Published	05/06/2024	Renal function testsestimations of GFR since GFR cannot be directly measuredmeasure {{c1::inulin clearance}}gold standard for GFR since {{c2::it is fi…
Published	05/06/2024	Plasma clearancedefinition -- {{c1::plasma volume cleared of a substance per time }}equation -- {{c2::}}
Published	05/06/2024	Measured CrCl (creatinine clearance)Ucr – {{c1::urine creatinine concentration }}Scr – {{c1::serum creatinine concentration}}equation for CrCl&nb…
Published	05/06/2024	Estimating GFR using SCr Cockcroft-GaultCrCl (mL/min) = {{c1::(140 – age) x kg / (72 x Scr) }}{{c1::x 0.85}} if female IBW (men) = {{c2::50 …
Published	05/06/2024	fractional excretion of Na
Published	05/06/2024	UTIdef. -- {{c1::inflammation of urethra/ bladder (cystitis) }}caused by {{c1::E. coli (80-85%)}} and {{c1::Staph (1-5%) }} Women more …
Published	05/06/2024	Urolithiasis – {{c1::Kidney Stones}}Renal calculi composed of {{c2::calcium (oxalate or phosphate) }}form in {{c2::kidney}} → pass through {…
Published	05/06/2024	Acute Kidney Injury (AKI){{c1::Abrupt and rapid deterioration of kidney function}} as evidenced by {{c2::Accumulation of nitrogenous wastes (BUN …
Published	05/06/2024	Prenatal Azotemia EtiologyMost common due to {{c1::renal hypoperfusion }}{{c2::Inadequate blood flow to kidney }}{{c2::Intravascular volume deple…
Published	05/06/2024	BUN/ Scr RatioNormal → {{c1::10 - 20 }}{{c2::> 20}} → prerenal azotemia If fraction sodium {{c2::< 1}} too → prerenal azo 15 → {{…
Published	05/06/2024	Prerenal Azotemia Lab parameters GFR will {{c1::decrease}} BUN Cr ratio {{c1::> 20 }}Na is {{c2::reabsorbed effectively }}the k…
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Published	05/06/2024	Postrenal AzotemiaCommonly due to a {{c1::obstruction of the ureters (blockage of urine flow)}}{{c1::prostatic hypertrophy, tumors, stones}} rena…
Published	05/06/2024	Intrarenal Azo Causes{{c1::Acute tubular necrosis (ATN)}} – 85% {{c2::Cut off blood → tubular cell death }}Caused by {{c3::toxins}} or {{c3:…
Published	05/06/2024	Intrinsic renal disease – Acute Tubular Necrosis (ATN)Cause {{c1::Ischemia}} ({{c2::thrombosis}}, {{c2::hypoperfusion}}) → {{c4::renal vasoconstr…
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Published	05/06/2024	Drug induced ATN cause {{c1::renal vasoconstriction}} and/or {{c1::tubular epithelial cell toxicity }}typicaly {{c2::Exogenous nephrotoxins}}{{c3…
Published	05/06/2024	Endogenous nephrotoxins  result -- {{c1::Kills tubule}}{{c6::Myoglobin (rhabdomyolysis)}} – {{c2::breakdown of skeletal muscle fibers → myoglobin…
Published	05/06/2024	Chronic Kidney Disease (CKD) general characteristicsdefinition -- {{c1::Progressive loss of kidney function }}Chronic injury → {{c1::irreversible…
Published	05/06/2024	CKD StagesAzotemia over years – asymptomatic, but signs and symptoms of uremia generally prevail Symptoms are due to …. {{c1::Buildup of was…
Published	05/06/2024	CKD lab findings{{c1::Progressive elevation in BUN and Cr (waste) }}{{c1::Isosthenuria - inability to concentrate urine}} {{c2::Proteinuria}…
Published	05/06/2024	CKD – Signs + Symptoms of Uremia{{c1::Fatigue, weakness }}{{c1::Bruises easily }}{{c2::Platelet dysfunction, low EPO }}{{c3::Metallic t…
Published	05/06/2024	Polycystic kidneysdefinition -- {{c1::Enlarged kidneys with cysts of varying size }}Cause – {{c2::mutations → defective proteins in renal tubular…
Published	05/06/2024	Effects of aging on the kidney{{c1::Gradual decrease in size of kidneys}}, but only ⅓ of one kidney necessary for homeostasis {{c1::blood flowing…
Published	05/06/2024	Renin-Angiotensin-Aldosterone System (RAAS){{c1::Angiotensinogen made in the liver }}{{c2::Low BP → renin released by JG cells of kidney }}{…
Published	05/06/2024	Drugs used to decrease CKD progressiondrugs that reduce {{c1::albuminuria}} and manage causes of CKD – {{c1::hypertension}} and {{c1::diabetes}} …
Published	05/06/2024	CKD secondary complications {{c1::fluid and electrolyte disorders }}CKD → {{c4::impaired K and PO4 secretion }}{{c1::Anemia}} CKD …
Published	05/06/2024	CKD – Anemiamultifactorial with {{c1::loss of RPO synthesis}}, {{c1::iron deficiency}}, and {{c1::inflammation}} Adequate iron supply is necessar…
Published	05/06/2024	CKD – secondary hyperparathyroidismManagement of {{c1::PTH}}, {{c1::phosphorus}}, and {{c1::calcium}} is important in preventing CKD-MBD and CV and ex…
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Published	05/06/2024	Regulation of fluid homeostasis {{c1::ADH }}Stimulus for ADH – {{c2::low BP, high osmolality }}{{c1::Thirst mechanism }}{{c1::Aldostero…
Published	05/06/2024	Regulation of fluid homeostasis – ADH{{c1::Hypothalamic osmoreceptors detect high blood osmolality → ADH release }}{{c2::Carotid baroreceptors de…
Published	05/06/2024	ADH related disordersSIADH – {{c1::syndrome of inappropriate ADH secretion --> High ADH}} Causes {{c2::Cancer – brain, lung }}{{c2::…
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Published	05/06/2024	Potassium (K)Hyperkalemia (> 5.1 mEq/L) Causes {{c1::Excessive K+ intake }}{{c1::Dec. K+ excretion }}{{c2::renal failure }…
Published	05/06/2024	CalciumBone is a {{c1::Ca2+ reservoir }}Calcitonin (from {{c2::thyroid}}) {{c3::Inhibits osteoclasts which breakdown bone }}{{c3::Stimu…
Published	05/06/2024	Metabolic alkalosis pH {{c1::> 7.45 }}{{c1::Excess base or loss of H+ }}Causes Acid loss → {{c2::vomiting, hypokalemia }}Excess…
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