Renal Failure Overview
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Questions and Answers

What is the hallmark of Acute Kidney Injury (AKI)?

  • Decreased glomerular filtration rate (GFR)
  • Increased serum creatinine
  • Increased blood urea nitrogen
  • All of the above (correct)

    • The normal glomerular filtration rate (GFR) is 125 mL/min.

    True (A)

    What is the primary function of the kidneys?

  • To filter waste products from the blood (correct)
  • To regulate blood pressure
  • To produce red blood cells
  • All of the above

    • Which of the following is a risk factor for Acute Kidney Injury (AKI)?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the most accurate indicator of fluid loss or gain in an acutely ill patient?

    <p>Weight (B)</p> Signup and view all the answers

    Chronic Kidney Disease (CKD) is defined as damage to the kidneys with or without a decreased GFR for ______ months or more.

    <p>3</p> Signup and view all the answers

    What is the most common cause of Chronic Kidney Disease (CKD)?

    <p>Diabetes</p> Signup and view all the answers

    What is the most common type of urinary diversion?

    <p>Ileal conduit (A)</p> Signup and view all the answers

    Which of the following is a common complication of Urinary Tract Infections (UTIs)?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the most common organism that causes UTIs?

    <p>Escherichia coli</p> Signup and view all the answers

    What is the most accurate measurement of kidney function?

    <p>Creatinine clearance (C)</p> Signup and view all the answers

    The presence of protein in the urine is a normal finding.

    <p>False (B)</p> Signup and view all the answers

    A normal urine output for adults is about ______ to ______ mL/day.

    <p>1500 to 2000</p> Signup and view all the answers

    Which of the following is a common treatment for UTIs?

    <p>All of the above (D)</p> Signup and view all the answers

    Kidney stones are more common in women than in men.

    <p>False (B)</p> Signup and view all the answers

    What is the most common type of kidney stone?

    <p>Calcium oxalate (C)</p> Signup and view all the answers

    What is the most common symptom of kidney stones?

    <p>Severe flank pain (A)</p> Signup and view all the answers

    Which of the following is a common treatment for kidney stones?

    <p>All of the above (D)</p> Signup and view all the answers

    Chronic kidney disease (CKD) is a reversible condition.

    <p>False (B)</p> Signup and view all the answers

    Patients with CKD are at increased risk for developing cardiovascular disease.

    <p>True (A)</p> Signup and view all the answers

    What is the most common cause of CKD in the United States?

    <p>Diabetes</p> Signup and view all the answers

    What is the hallmark of Chronic Kidney Disease (CKD)?

    <p>All of the above (D)</p> Signup and view all the answers

    The most effective way to manage CKD is to receive a kidney transplant.

    <p>False (B)</p> Signup and view all the answers

    What are the three categories that cause Acute Kidney Injury (AKI)?

    <p>Pre-renal, Intra-renal, Post-renal (C)</p> Signup and view all the answers

    Chronic Kidney Disease has a cure and can be reversed with proper treatment.

    <p>False (B)</p> Signup and view all the answers

    What is the primary cause of Chronic Kidney Disease?

    <p>Diabetes</p> Signup and view all the answers

    What is the normal range for blood urea nitrogen (BUN) levels in a healthy adult?

    <p>10-20 mg/dL (B)</p> Signup and view all the answers

    What is the normal range for Creatinine levels in a healthy adult?

    <p>0.6-1.2 mg/dL (C)</p> Signup and view all the answers

    Kidney function tests are only conducted when an individual exhibits symptoms.

    <p>False (B)</p> Signup and view all the answers

    Which of these is NOT a common manifestation of Urinary Tract Infection (UTI)?

    <p>Constipation (B)</p> Signup and view all the answers

    What is the ideal medication for treating UTI?

    <p>Antibacterial agent</p> Signup and view all the answers

    What is the primary reason for performing a cystoscopy?

    <p>To identify the source of recurrent urinary tract infections (D)</p> Signup and view all the answers

    Which of these is NOT a primary risk factor for urinary incontinence?

    <p>Low Blood Pressure (D)</p> Signup and view all the answers

    What is the medical term used to describe the presence of bacteria in the urine?

    <p>Bacteriuria</p> Signup and view all the answers

    Urinary retention is the inability to empty the bladder completely despite trying.

    <p>True (A)</p> Signup and view all the answers

    What is the most common complication of urinary retention?

    <p>Urinary tract infections (D)</p> Signup and view all the answers

    What is the name for the dysfunction that results from a lesion in the nervous system and leads to urinary incontinence?

    <p>Neurogenic bladder</p> Signup and view all the answers

    Renal calculi, commonly known as kidney stones, are a major complication of urinary retention.

    <p>True (A)</p> Signup and view all the answers

    Which of these conditions can predispose a person to developing kidney stones?

    <p>All of the above (D)</p> Signup and view all the answers

    Match the types of kidney stones with their primary composition.

    <p>Calcium Oxalate = About 75% of stones contain calcium oxalate, which may be a combination of calcium oxalate, calcium phosphate, or triple phosphate Struvite = Struvite stones are composed of calcium, magnesium, and ammonium phosphate Uric Acid = Increased urate excretion, fluid depletion, and an inherited defect in renal absorption of the amino acids lead to the formation of these stones</p> Signup and view all the answers

    Extracorporeal Shock Wave Lithotripsy (ESWL) is a non-invasive procedure that breaks down kidney stones using shock waves.

    <p>True (A)</p> Signup and view all the answers

    What is the most common type of urinary diversion procedure?

    <p>Ileal conduit</p> Signup and view all the answers

    Renal disorders always manifest with clear symptoms and are easily diagnosed.

    <p>False (B)</p> Signup and view all the answers

    Which of the following is a common manifestation of Chronic Kidney Disease (CKD)?

    <p>Muscle weakness (B)</p> Signup and view all the answers

    Flashcards

    Acute Renal Failure (ARF)

    Abrupt reduction in kidney function, causing progressive waste product buildup.

    Chronic Renal Failure (CRF)

    Kidney damage or decreased filtration rate for over 3 months.

    Serum Creatinine

    Blood test showing kidney's filtering ability (higher levels mean poorer function).

    Blood Urea Nitrogen (BUN)

    Blood test measuring urea (waste product) levels, reflecting kidney function.

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    Azotemia

    Buildup of nitrogenous waste products in the blood, often due to kidney issues.

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    GFR (Glomerular Filtration Rate)

    Rate at which kidneys filter blood (125 mL/min in healthy adults).

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    AKI (Acute Kidney Injury)

    Sudden decrease in kidney function, lasting less than 3 months.

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    Creatinine Criteria (AKI)

    Increased serum creatinine by a specified amount (1.5 - 3x or >4) within a period of time, indicating kidney damage.

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    Urine Output Criteria (AKI)

    Reduced urine production (below a certain threshold, e.g., <0.5 mL/kg/hr) for a specific time period.

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    AKI Stage 1

    Mild increase in serum creatinine or reduced urine output for 6 hrs.

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    AKI Stage 2

    Moderate AKI: increase in serum creatinine or reduced urine output for 12 hrs.

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    AKI Stage 3

    Severe AKI: marked increase in serum creatinine or reduced urine output for 24 hrs or more.

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    RIFLE Criteria

    Older staging system for AKI based on risk, injury, failure, loss, end-stage.

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    KDIGO Criteria

    Current staging system for AKI based on serum creatinine, urine output.

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    Ischemic Injury

    Kidney damage due to reduced blood flow.

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    Nephrotoxic Injury

    Kidney damage from harmful substances.

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    Inflammatory Injury

    Kidney inflammation causing AKI, e.g. glomerulonephritis.

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    What is renal failure?

    A condition where the kidneys can't filter waste products from the blood effectively.

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    What is the difference between Acute Renal Failure (ARF) and Chronic Renal Failure (CRF)?

    ARF is a sudden decrease in kidney function, while CRF is a long-term decline.

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    What are the hallmarks of ARF?

    Abrupt reduction in kidney function, leading to waste product buildup (creatinine, urea), electrolyte imbalances, and problems with blood pressure regulation.

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    What is a key indicator of kidney function?

    Glomerular Filtration Rate (GFR), which measures the rate at which the kidneys filter blood.

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    What is Azotemia?

    A buildup of nitrogenous waste products in the blood, often due to kidney issues.

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    What is serum creatinine?

    A blood test that measures creatinine levels, which provide information about kidney function.

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    What is Blood Urea Nitrogen (BUN)?

    A blood test measuring urea levels, which indicate how well the kidneys are clearing waste.

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    How are Serum Creatinine and BUN related to kidney function?

    Higher levels of serum creatinine and BUN indicate poorer kidney function.

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    What is the significance of GFR in relation to kidney function?

    GFR is a direct measure of kidney function, with a healthy adult having a GFR of 125 ml/min.

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    What is the definition of AKI (Acute Kidney Injury) according to KDIGO guidelines?

    AKI is defined as a sharp increase in serum creatinine, or a reduced urine output for a specified period.

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    What are the criteria for diagnosing AKI based on serum creatinine?

    An increase in serum creatinine of ≥0.3 mg/dL within 48 hours or ≥1.5 times baseline within 7 days.

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    What are the criteria for diagnosing AKI based on urine output?

    A urine volume less than or equal to 0.5 mL/kg/hr for 6 hours.

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    What are the RIFLE and KDIGO criteria used for?

    These are staging systems for AKI. RIFLE (Risk, Injury, Failure, Loss, End-stage) is an older system whereas KDIGO is the current system.

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    What are the stages of AKI according to KDIGO?

    AKI is staged from 1 to 3 based on serum creatinine levels and urine output.

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    What characterizes AKI Stage 1?

    A mild increase in serum creatinine (1.5-1.9 times baseline or ≥0.3 mg/dL) within 48 hours, or a urine output less than 0.5 mL/kg/hr for 6-12 hours.

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    What characterizes AKI Stage 2?

    A moderate increase in serum creatinine (2-2.9 times baseline) within 7 days, or a urine output less than 0.5 mL/kg/hr for ≥12 hours.

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    What characterizes AKI Stage 3?

    A severe increase in serum creatinine (≥3 times baseline or ≥4 mg/dL), or a urine output less than 0.3 mL/kg/hr for 24 hours or complete absence of urine (anuria) for ≥12 hours.

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    What are some conditions that can damage the kidneys and lead to AKI?

    Conditions that can cause AKI include ischemic injury (reduced blood flow), nephrotoxic injury (harmful substances damaging the kidneys), and inflammatory injury (inflammation causing kidney damage).

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    What is ischemic injury to the kidneys?

    Damage to kidneys due to reduced blood flow, often caused by prolonged decreased renal perfusion, septic shock, transfusion reactions, or trauma/crush injury.

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    What is nephrotoxic injury to the kidneys?

    Damage to kidneys caused by exposure to harmful substances, including antibiotics, fungicides, gram(-) toxins, pesticides, radiographic dyes.

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    What is inflammatory injury to the kidneys?

    Kidney inflammation causing AKI, often due to conditions like acute glomerulonephritis or acute tubular necrosis.

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    What is the difference between AKI stages and AKI criteria?

    AKI criteria are the specific thresholds for diagnosing AKI based on serum creatinine or urine output. AKI stages are classifications of severity based on those criteria.

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    Study Notes

    Renal Failure

    • Reduction in kidney's ability to filter waste products from blood.
    • Two main types: Acute Renal Failure (ARF) and Chronic Renal Failure (CRF).

    Acute Renal Failure (ARF)

    • Abrupt reduction in renal function.
    • Progressive retention of metabolic waste products (creatinine and urea).
    • Electrolyte imbalances occur.
    • Acid-base balance problems, calcium and phosphate metabolism issues, blood pressure regulation issues, and erythropoiesis issues.
    • Key features include increased serum creatinine (2-3x baseline) and urine output <0.5 mL/kg/hr x 12 hours.

    Chronic Renal Failure (CRF)

    • Presence of kidney damage or decreased glomerular filtration rate (GFR) for more than 3 months.
    • Gradual reduction in kidney function.

    AKI Staging Criteria: RIFLE Criteria (2004)

    • Risk: 1.5-2x baseline serum creatinine, urine output <0.5 mL/kg/hr x 6 hours.
    • Injury: Serum creatinine increase by 1.5-2x or 0.3 mg/dL, Urine output <0.5 mL/kg/hr x 12 hours.
    • Failure: Serum creatinine 3x baseline, urine output <0.3 mL/kg/hr x 24 hours, or anuria for 12 hours.

    AKI Staging Criteria: AKIN Criteria (2007)

    • Stage 1: Serum creatinine increase 1.5-2x, urine output <0.5 mL/kg/hr x 6 hours.
    • Stage 2: Serum creatinine increase 2-3x, urine output <0.5 mL/kg/hr x 12 hours.
    • Stage 3: Serum creatinine 3x baseline or >4 mg/dL, urine output <0.3 mL/kg/hr x 24 hrs, or anuria for 12 hours.

    AKI Staging Criteria: KDIGO Criteria

    • Stage 1: Serum creatinine 1.5-1.9 x baseline or ≥ 0.3 mg/dL increase within 48 hours; Urine output < 0.5 mL/kg/hr x 6-12 hours.

    Risk Factors for AKI

    • Hypovolemia
    • Burns
    • Excessive use of diuretics
    • Glomerular loss
    • Shock
    • Hemorrhage

    Renal Replacement Therapy

    • Treatment for severe AKI.
    • Two types: IHD and CRRT.

    Peritoneal Dialysis (PD)

    • Common approach to renal replacement therapy in patients with CKD.
    • Introduces sterile dialyzing fluid into the abdominal cavity, allows fluid removal, and facilitates waste removal.

    Kidney Transplant

    • Implanating a kidney from a living or deceased donor into a recipient with renal failure.
    • Aims to maintain patient homeostasis until transplant function is improved.

    Chronic Kidney Disease (CKD)

    • Umbrella term for kidney damage lasting 3 or more months.
    • Often caused by diabetes and hypertension.
    • Five stages, starting with normal GFR levels, ending with GFR below 15 mL/min.

    Management of CKD

    • Treatment of the underlying cause and regular clinical assessments for optimal blood pressure readings.
    • Early referral for renal replacement therapy as needed.
    • Smoking cessation, weight reduction, and exercise, as needed.

    Nephrosclerosis

    • Hardening of the renal arteries.
    • Typically caused by prolonged hypertension or diabetes.
    • Aggressive antihypertensive therapy is crucial for management.

    Acute Nephritic Syndrome

    • Clinical manifestation of glomerular inflammation.
    • Primary symptoms: hematuria, edema, azotemia, and proteinuria.
    • Severe cases may result in heart or pulmonary complications.

    Nephrotic Syndrome

    • Characterized by increased glomerular permeability and massive proteinuria.
    • Severe complication of glomerular inflammation.
    • Main manifestation is edema.
    • Treatment options include diuretics, ACE inhibitors, and lipid-lowering agents.

    Polycystic Kidney Disease (PKD)

    • Genetic disorder presenting with numerous kidney cysts.
    • Cysts fill with fluid, destroying nephrons.
    • Manifestations may include hematuria, polyuria, hypertension, renal calculi, and urinary tract infections.
    • Treatment options are supportive, including blood pressure control, pain management, and antibiotics for infections.

    Renal Failure (End-stage disease)

    • Progressive irreversible loss of kidney function.
    • Symptoms severity and complications depend on disease stage and age.
    • Common issues include hyperkalemia, pericarditis, hypertension, and bone disease.
    • Treatment includes calcium and phosphate binders, antihypertensive medications, and sometimes dialysis.

    Urinary Tract Infections (UTIs)

    • Infections caused by pathogenic microorganisms.
    • Common risk factors include inability to empty the bladder, decreased natural defenses, immunosuppression, instrumentation, or inflammation of the urethral mucosa.
    • Symptoms may include pain, burning, frequent urination, nocturia, incontinence, or hematuria.
    • Treatment is with antibacterial agents, fluids, and avoiding urinary irritants.

    Urinary Incontinence

    • Involuntary loss of urine from the bladder.
    • Different types include stress, urge, functional, and mixed.
    • Risk factors include pregnancy, menopause, surgery, immobility, high-impact exercise, and diabetes.
    • Treatment involves behavioral therapy, pelvic floor exercises, medications, and sometimes surgery.

    Urinary Retention

    • Inability to completely empty the bladder.
    • Contributing factors include, but aren't limited to diabetes, prostatic enlargement, urethral pathology, trauma, pregnancy, or neurological disorders.
    • Complication may include chronic infections, renal calculi, pyelonephritis, sepsis, or hydronephrosis.
    • Treatment involves promoting urinary elimination, providing privacy and comfort, and initiating catheterization if needed, followed by bladder retraining.

    Urolithiasis and Nephrolithiasis

    • Stones (calculi) in the urinary tract (kidney, ureter, or bladder).
    • Symptoms depend on location, obstruction or infection.
    • Pain and hematuria are common.
    • Treatment may include NSAIDs, opioid analgesics, and dietary changes, or surgical options like extracorporeal shock wave lithotripsy (ESWL).

    Urinary Diversions

    • Changing urine excretion sites via surgically created stomas in skin.
    • Ileal conduit is a common type.
    • Frequent post-surgical assessment and management are required to maintain stoma viability and prevent complications.

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    Renal Failure PPT PDF

    Description

    This quiz covers the key aspects of renal failure, including the differences between Acute Renal Failure (ARF) and Chronic Renal Failure (CRF). It highlights the symptoms, causes, and the RIFLE criteria for staging acute kidney injury. Test your knowledge on how renal function is assessed and the implications of kidney damage.

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