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Questions and Answers
What is one result of chronic renal failure on the body's systems?
What is one result of chronic renal failure on the body's systems?
- Increased metabolic rate
- Enhanced red blood cell production
- Elevated blood pressure (correct)
- Decreased susceptibility to infections
Which stage of chronic renal failure is characterized by a negligible glomerular filtration rate (GFR)?
Which stage of chronic renal failure is characterized by a negligible glomerular filtration rate (GFR)?
- End-stage renal failure (correct)
- Pre-renal failure
- Decreased renal reserve
- Renal insufficiency
What is a significant symptom associated with decreased erythropoiesis in chronic renal failure?
What is a significant symptom associated with decreased erythropoiesis in chronic renal failure?
- Increased energy levels
- Anemia (correct)
- Hyperactivity
- Weight gain
What condition is NOT commonly associated with chronic renal failure?
What condition is NOT commonly associated with chronic renal failure?
Which of the following is a primary goal of dialysis in patients with renal failure?
Which of the following is a primary goal of dialysis in patients with renal failure?
What is an early sign of chronic renal failure?
What is an early sign of chronic renal failure?
What does azotemia indicate in the context of end-stage renal failure?
What does azotemia indicate in the context of end-stage renal failure?
Which of these is a long-term consequence of low-level nephrotoxin exposure?
Which of these is a long-term consequence of low-level nephrotoxin exposure?
What is the primary function of the glomerular filtration rate (GFR)?
What is the primary function of the glomerular filtration rate (GFR)?
Which substance is produced by the kidneys and is vital for red blood cell production?
Which substance is produced by the kidneys and is vital for red blood cell production?
What characterizes normal protein excretion in urine?
What characterizes normal protein excretion in urine?
How much renal blood flow does the kidney generally receive relative to cardiac output?
How much renal blood flow does the kidney generally receive relative to cardiac output?
What barrier prevents proteins from leaking through the glomerular filtration membrane during ultrafiltration?
What barrier prevents proteins from leaking through the glomerular filtration membrane during ultrafiltration?
Which kidney function involves the passage of a large volume of fluid from glomerular capillaries into the tubule?
Which kidney function involves the passage of a large volume of fluid from glomerular capillaries into the tubule?
What role does the kidneys play in the activation of vitamin D?
What role does the kidneys play in the activation of vitamin D?
Which of the following substances is not typically removed from the body by the urinary system?
Which of the following substances is not typically removed from the body by the urinary system?
What primarily causes increased permeability in glomerular capillaries associated with nephrotic syndrome?
What primarily causes increased permeability in glomerular capillaries associated with nephrotic syndrome?
What symptom indicates the presence of nephrotic syndrome?
What symptom indicates the presence of nephrotic syndrome?
Which type of stone is most likely to form in the urinary tract due to excessive solutes in the filtrate?
Which type of stone is most likely to form in the urinary tract due to excessive solutes in the filtrate?
What is a major factor contributing to the formation of calculi in urolithiasis?
What is a major factor contributing to the formation of calculi in urolithiasis?
In nephrotic syndrome, what effect does decreased plasma osmotic pressure have on the body?
In nephrotic syndrome, what effect does decreased plasma osmotic pressure have on the body?
What urinary symptom is commonly associated with obstruction in urolithiasis?
What urinary symptom is commonly associated with obstruction in urolithiasis?
Which condition is related to uric acid stone formation?
Which condition is related to uric acid stone formation?
What physiological change may occur in response to reduced blood volume in nephrotic syndrome?
What physiological change may occur in response to reduced blood volume in nephrotic syndrome?
What symptom is commonly associated with complete chronic renal failure?
What symptom is commonly associated with complete chronic renal failure?
Which of the following electrolyte imbalances is typically present in end-stage renal failure?
Which of the following electrolyte imbalances is typically present in end-stage renal failure?
Which of the following statements about the treatment of chronic renal failure is true?
Which of the following statements about the treatment of chronic renal failure is true?
Which factor influences the manifestations of renal failure?
Which factor influences the manifestations of renal failure?
What is the expected effect on acid-base balance in patients with chronic renal failure?
What is the expected effect on acid-base balance in patients with chronic renal failure?
What condition results from the failure of the kidneys to activate vitamin D?
What condition results from the failure of the kidneys to activate vitamin D?
How does systemic acidosis affect potassium levels in end-stage renal failure?
How does systemic acidosis affect potassium levels in end-stage renal failure?
Which aspect of renal failure treatment focuses on dietary restrictions?
Which aspect of renal failure treatment focuses on dietary restrictions?
What condition is a person with end-stage renal failure most likely experiencing due to impaired kidney function?
What condition is a person with end-stage renal failure most likely experiencing due to impaired kidney function?
Which hematologic disorder is most commonly associated with renal failure?
Which hematologic disorder is most commonly associated with renal failure?
What is a likely cardiovascular complication that may arise from end-stage renal failure?
What is a likely cardiovascular complication that may arise from end-stage renal failure?
What condition can lead to joint problems in uremic patients, resulting in arthritis?
What condition can lead to joint problems in uremic patients, resulting in arthritis?
In end-stage renal disease, a probable cause of pruritus is attributed to which factor?
In end-stage renal disease, a probable cause of pruritus is attributed to which factor?
Which of the following is NOT a common pulmonary complication associated with end-stage renal failure?
Which of the following is NOT a common pulmonary complication associated with end-stage renal failure?
What is the primary mechanism through which hypertension develops in patients with renal disease?
What is the primary mechanism through which hypertension develops in patients with renal disease?
What critical laboratory finding indicates azotemia in patients with renal failure?
What critical laboratory finding indicates azotemia in patients with renal failure?
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Study Notes
Nephrotic Syndrome
- Characterized by abnormalities in glomerular capillaries leading to increased permeability, causing significant plasma protein loss.
- Most common in children aged 2 to 6, can also be secondary to conditions like SLE and nephrotoxins.
Pathophysiology
- Hypoalbuminemia results in decreased plasma osmotic pressure, leading to generalized edema.
- Blood pressure can remain low or normal; elevated in some cases due to angiotensin II impact.
- Increased aldosterone secretion occurs due to reduced blood volume, worsening edema.
- Presence of high blood cholesterol and lipoprotein in urine, resulting in lipiduria with a milky appearance.
Signs and Symptoms
- Key symptoms include proteinuria, lipiduria, and urine casts.
- Massive edema and sudden increase in abdominal girth.
Urinary Tract Obstructions
- Includes conditions like urolithiasis, hydronephrosis, and tumors affecting urine flow.
Urolithiasis (Calculi)
- Stones can form anywhere in the urinary tract; may vary in size.
- Factors promoting stone formation include high solutes in urine, insufficient fluid intake, and urinary tract infections.
Urolithiasis Symptoms
- Often asymptomatic unless urine flow obstruction occurs, which may lead to infections and hydronephrosis.
Causes of Urolithiasis
- Calcium salts stones develop with high urine calcium and alkaline urine.
- Uric acid stones are linked to hyperuricemia from gout and chemotherapy, especially in acidic urine.
- Cystine stones form under certain predispositions.
Urinary System Functions
- Responsible for removing metabolic wastes, hormones, drugs, and foreign materials.
- Regulates water, electrolytes, acid-base balance, and produces erythropoietin.
- Activates vitamin D and helps regulate blood pressure through the renin-angiotensin-aldosterone system.
Renal Function & Indicators
- Glomerular filtration rate (GFR) measures renal function; normal GFR is 125 ml/min in males and 115 ml/min in females.
- Kidney blood flow constitutes 20-25% of cardiac output, making it susceptible to drug toxicity.
- Normal urine protein excretion is under 150 mg/day; greater amounts indicate pathology.
Chronic Renal Failure
- Gradual, irreversible destruction of kidneys, often asymptomatic initially.
- May arise from chronic kidney disease, congenital disorders, systemic diseases, or nephrotoxins.
Chronic Renal Failure Stages
- Decreased Renal Reserve: Initial GFR decline with no clinical symptoms.
- Renal Insufficiency: GFR drops to about 20%, with retention of nitrogen wastes and high blood pressure.
- End-Stage Renal Failure: Negligible GFR, retention of body fluids and wastes, requiring dialysis or transplantation.
Early Signs of Chronic Renal Failure
- Increased urinary output often accompanied by general symptoms like nausea, anemia, fatigue, and unintended weight loss.
Complete Renal Failure Symptoms
- Oliguria, skin changes, peripheral neuropathy, hormonal irregularities, encephalopathy, and systemic infections.
Diagnostic Tests and Indicators
- Monitor for metabolic acidosis, azotemia, severe anemia, and electrolyte imbalances like hyponatremia and hyperkalemia.
Treatment Approaches
- Focused on maintaining homeostasis of fluids and electrolytes, treating cardiovascular issues, and adopting dietary restrictions.
- May require dialysis or kidney transplantation for life maintenance.
Factors Influencing Renal Failure Manifestations
- Extent of remaining renal function, concurrent disease conditions, and type of renal replacement therapy being received.
Disorders Associated with Renal Failure
- Can lead to anemia, coagulopathies, hypertension, heart disease, and susceptibility to infections.
Urinary System Disorders Effect
- Abnormal internal metabolism of proteins and carbohydrates in end-stage renal disease; may also present with pulmonary complications and hemolytic issues.
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