Kidney Function and Acute Injury Electrolytes

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Questions and Answers

What is one of the endocrine functions of the kidneys?

Secretion of glucagon

Production of insulin

Regulation of blood pressure

Activation of vitamin D (correct)

What is the role of erythropoietin produced by the kidneys?

Stimulates kidney filtration

Controls blood glucose levels

Regulates calcium absorption

Regulates the quantity of red blood cells (correct)

Which electrolyte is responsible for maintaining osmotic pressure in extracellular fluid?

Phosphorus

Sodium (correct)

Potassium

Calcium

What is the typical range for potassium levels in the body?

3.5-5.0 mEq/L Signup and view all the answers

What potential condition may occur if the kidneys are unable to excrete hydrogen ions?

Metabolic Acidosis Signup and view all the answers

What is a consequence of reduced calcium levels in renal failure?

Stimulation of parathyroid hormone Signup and view all the answers

Which condition is likely to develop due to excessive stimulation of parathyroid hormone in chronic kidney disease?

Osteodystrophy Signup and view all the answers

What happens to phosphorus levels in kidney damage?

Phosphorus levels increase due to decreased excretion Signup and view all the answers

What is the main consequence of reduced erythropoietin levels in kidney failure?

Decreased red blood cell production Signup and view all the answers

What is the adequate level of Glomerular Filtration Rate (GFR) for kidney function?

90-120 mL per minute Signup and view all the answers

What is likely indicated by high levels of protein in urine?

Impairment in glomerulus function Signup and view all the answers

In chronic renal failure, what is impaired leading to hypocalcemia?

Vitamin D production Signup and view all the answers

What is the normal range for BUN levels if kidney function is adequate?

Normal BUN levels indicate proper waste filtration Signup and view all the answers

What does the term 'uremia' refer to?

Abnormally high waste products in the blood Signup and view all the answers

What condition is characterized by an abnormal increase of nitrogen waste products in the blood?

Azotemia Signup and view all the answers

What is a potential outcome if GFR falls below 15 mL per minute?

End stage renal disease Signup and view all the answers

What characterizes prerenal azotemia?

Reduced blood flow to the kidneys without structural damage. Signup and view all the answers

Which condition is a possible cause of prerenal azotemia?

Dehydration. Signup and view all the answers

What happens in intrinsic (renal) azotemia?

There is direct damage to kidney structures. Signup and view all the answers

What is a normal BUN level?

6-20 mg/dL Signup and view all the answers

NSAIDs can precipitate prerenal failure by causing what effect?

Vasoconstriction of afferent arterioles. Signup and view all the answers

Which of the following describes postrenal azotemia?

Obstruction of urine outflow. Signup and view all the answers

What is typically retained in prerenal azotemia?

Kidneys can still concentrate urine and reabsorb BUN. Signup and view all the answers

How does hypotension relate to azotemia?

It tends to precipitate azotemia due to reduced blood flow. Signup and view all the answers

What is the most common cause of intrarenal acute kidney injury?

Acute tubular necrosis Signup and view all the answers

Which of the following conditions can lead to rhabdomyolysis?

Crushing injury Signup and view all the answers

Which type of antibiotic is known to be nephrotoxic and ototoxic?

Aminoglycosides Signup and view all the answers

What happens during the initial phase of acute tubular necrosis?

Kidney tubules suffer damage Signup and view all the answers

What is a symptom of the maintenance phase of acute tubular necrosis?

Decreased urine output (oliguria) Signup and view all the answers

Which condition can lead to postrenal acute kidney injury?

Benign prostatic hyperplasia Signup and view all the answers

What laboratory values are monitored for nephrotoxic antibiotic use?

BUN and creatinine Signup and view all the answers

Which of the following is a clinical manifestation of acute kidney injury?

Elevated blood pressure Signup and view all the answers

What is a common indicator of acute kidney injury (AKI) as assessed through urinalysis?

Elevated RBCs and WBCs Signup and view all the answers

Which of the following medications can help remove excess potassium in hyperkalemia?

Bumex/bumetanide Signup and view all the answers

How is chronic kidney disease typically differentiated from end-stage renal disease (ESRD) through renal ultrasonography?

By identifying the shape of the kidneys Signup and view all the answers

What role do osmotic diuretics play in the management of acute kidney injury?

They maintain urinary output Signup and view all the answers

Which type of dialysis is considered the gold standard for patients requiring renal replacement therapy?

Arteriovenous fistula Signup and view all the answers

What is the primary purpose of using calcium chloride in cases of hyperkalemia?

To restore calcium balance Signup and view all the answers

In the context of renal failure, which test result would most likely indicate metabolic acidosis?

Altered arterial blood gases Signup and view all the answers

Which diuretics specifically target potassium excretion?

Loop diuretics Signup and view all the answers

How many times per week is peritoneal dialysis typically performed?

What is a key requirement when performing peritoneal dialysis at home?

Employing aseptic technique Signup and view all the answers

Which type of peritoneal dialysis requires the patient to be connected to a machine at night?

Automated Peritoneal Dialysis Signup and view all the answers

What is a common effect of having a fistula for dialysis?

Audible sounds upon auscultation Signup and view all the answers

What complication can occur from elevated potassium levels in renal patients?

Hyperkalemia Signup and view all the answers

What is an essential practice when monitoring a patient undergoing dialysis?

Hourly monitoring of intake and output Signup and view all the answers

In what year was the law signed that recognized dialysis as a medical intervention?

1972 Signup and view all the answers

What is the purpose of using a high concentration of glucose in peritoneal dialysis fluid?

To increase osmotic pressure for waste removal Signup and view all the answers

Study Notes

Kidney Function

Responsible for maintaining fluid and electrolyte balance.
Removes water-soluble waste products.
Regulates the amount and composition of urine.
Produces erythropoietin (regulates red blood cell production).
Red blood cell reduction leads to less oxygen delivery to the kidneys.
Activates vitamin D, important for intestinal calcium absorption.
Filters over 7 liters of fluid per hour.
Excretes excess hydrogen ions (preventing metabolic acidosis).

Week 9 Acute Kidney Injury Electrolytes

Potassium: 3.5-5.0 mEq/L (intracellular); low or high levels can affect heart function.
Sodium: 135-145 mEq/L (low levels cause confusion, high levels cause water retention).

Week 9 Acute Kidney Injury Electrolytes (cont'd)

Low sodium causes muscle cramps and weakness.
Maintaining osmotic pressure in extracellular fluid is important.
Calcium: 8.5-10.5 mg/dL
Low calcium can cause parathyroid hormone release, increasing the risk of fractures.

Week 9 Acute Kidney Injury Phosphorus and Kidney Function

Phosphorus (3.9-4.5 mg/dL): Kidneys are the primary organ for excreting phosphorus, excretion is impaired in kidney failure.
High phosphorus and low calcium levels can affect acid-base balance.

Week 9 Acute Kidney Injury: Addressing Clinical Problems

Anemia due to kidney problems can be treated with erythropoietin (Epogen) replacement.
Reduced blood flow to the kidneys can be addressed by the renin-angiotensin-aldosterone system.
Damage to glomeruli can increase waste products in the kidney tubules.

Week 9 Acute Kidney Injury: GFR and End Stage Renal Disease

Glomerular filtration rate (GFR) of 90-120 mL/min is adequate.
GFR below 15 mL/min indicates end-stage renal disease.
large amount of protein in urine is a sign that glomerulus is not working properly.

Week 9 Acute Kidney Injury: Azotemia

Azotemia is a condition characterized by abnormal levels of nitrogenous waste products in the blood (e.g., BUN, creatinine).
Three types of azotemia: prerenal, intrinsic, and postrenal.
Prerenal azotemia can be reversed when addressing the underlying causes.

Week 9 Acute Kidney Injury: Intrinsic/Intrinsic Renal Azotemia

Intrinsic (renal) azotemia involves direct damage to the kidneys.
Examples include acute tubular necrosis and glomerulonephritis.

Week 9 Acute Kidney Injury: Postrenal Azotemia

Postrenal azotemia occurs due to obstruction of urine outflow.
Examples include kidney stones and enlarged prostate.

Week 9 Acute Kidney Injury: Causes and Prevention

Various conditions can lead to acute kidney injury, including dehydration and exposure to nephrotoxic substances.
Proper management, including maintaining appropriate hydration and avoiding nephrotoxins, can prevent acute kidney injury.

Week 9 Acute Kidney Injury: Radiographic Contrast and Rhabdomyolysis

Radiographic contrast media can cause tubular cell toxicity and ischemia.
Rhabdomyolysis is the breakdown of muscle tissue, releasing myoglobin into the blood, which can damage kidney tubules.

Week 9 Acute Kidney Injury: Treatment

Treatment strategies involve addressing the underlying cause of AKI and managing complications. Fluid balance, electrolyte levels, and waste product removal are crucial aspects of treatment.

Week 9 Acute Kidney Injury: Reversibility

If recognized early, acute kidney injury may be reversible.
Timely diagnosis and intervention can reduce the severity of damage.

Week 9 Acute Kidney Injury: Acute Tubular Necrosis (cont'd)

This is a severe condition that affects kidney tubules, and is often caused by insufficient blood flow.
Symptoms can include reduced urine output.

Week 9 Acute Kidney Injury: Medication

Diuretics, such as loop diuretics, can help manage fluid retention.
Osmotic diuretics can pull extracellular water into the bloodstream, helping to flush out waste products.

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Description

Explore the crucial functions of the kidneys in maintaining electrolyte balance and waste removal. This quiz focuses on the effects of acute kidney injury on electrolyte levels, including potassium, sodium, and calcium, and their implications for health. Test your knowledge on how these electrolytes impact kidney function and overall well-being.