Chapters 22 & 23: Renal and Urological Disorders

Questions and Answers

Glucose

Vitamin D

Urea (correct)

Protein

Erythropoietin

False

Glomerular Filtration Rate (GFR) Signup and view all the answers

Increased sodium reabsorption Signup and view all the answers

hydrogen ions Signup and view all the answers

Polycystic Kidney Disease (PKD) Signup and view all the answers

All of the above Signup and view all the answers

False Signup and view all the answers

Urine Creatinine Clearance (CrCl) Signup and view all the answers

Study Notes

Filtration: Eliminates metabolic wastes such as urea, uric acid, ammonia, and creatinine, along with drugs and foreign substances from the bloodstream.
Reabsorption: Balances water and electrolytes and maintains acid-base levels by excreting hydrogen ions and reabsorbing bicarbonate.
Secretion: Produces erythropoietin for red blood cell production, activates vitamin D for calcium absorption, and secretes renin to regulate blood pressure via the RAAS.

Antidiuretic Hormone (ADH):
- Produced by posterior pituitary.
- Responsible for water reabsorption; high levels result in concentrated urine, while low levels lead to dilute urine.
Aldosterone:
- Secreted by the adrenal cortex.
- Regulates sodium and water reabsorption to control fluid balance.

Glomerular Filtration Rate (GFR):
- Key measure of kidney function, indicating renal blood filtration per time unit.
- GFR over 90 mL/min suggests good kidney function; below 60 mL/min indicates diminished function.
- Blood pressure is closely linked to kidney health.

Activated by decreased kidney perfusion or low sodium levels.
Renin initiates the conversion of angiotensin to its active forms:
- Angiotensin causes vasoconstriction, raising blood pressure.
- Aldosterone promotes sodium and water reabsorption, thereby increasing blood volume and pressure.

GFR: Best indicator of kidney filtration effectiveness.
Urine Creatinine Clearance (CrCl): Measures kidney's ability to clear creatinine.
Serum Creatinine: Elevated levels indicate impaired kidney function.
Blood Urea Nitrogen (BUN): Assesses nitrogen waste in the blood.

Results in metabolic waste accumulation, leading to uremia, anemia, and cognitive disturbances.
Decreased urine production leads to oliguria or anuria.
Imbalances include:
- Hyperkalemia: Excess potassium linked to cardiac risks.
- Metabolic acidosis: Inefficient H+ ion excretion.
- Reduced erythropoietin leads to anemia; decreased vitamin D activation causes hypocalcemia.

Pyelonephritis:
- Kidney infection primarily caused by E. coli.
- Symptoms include flank pain, fever, chills, nausea, vomiting, and hematuria.
Acute Glomerulonephritis (AG):
- Often follows streptococcal infections, results in edema, oliguria, dark hematuria, and proteinuria.
Nephrotic Syndrome:
- Glomerular damage often due to diabetes, causing proteinuria, edema, and hypoalbuminemia, similar to AG.
Polycystic Kidney Disease (PKD):
- Genetic condition leading to cyst formation in kidneys, resulting in impaired function and hypertension.
- Symptoms include pain from cyst pressure, kidney stones, and hematuria.