What is nephrotic syndrome?
- correct answer A condition of increased glomerular permeability that allows larger molecules to pass
through the membrane into the urine and then be excreted.
What are key features of nephrotic syndrome?
- correct answer -*Massive proteinuria*
-*Hypoalbuminemia*
-*Edema (facial and periorbital)*
-Lipiduria
-Hyperlipidemia
-Increased coagulation
-Reduced kidney function
In nephrotic syndrome, severe protein loss in the urine is greater than what?
- correct answer 3.5g in 24 hours
What is nephrotic syndrome treated with?
- correct answer -immunosuppressant agents (if immunity based).
-ACE inhibitors (decreased protein loss in urine)
-statins (improve blood lipid levels).
-Heparin (used to treat vascular effects and improve kidney function)
Describe the "risk" stage for AKI
- correct answer creatinine x 1.5 of normal, and GFR reduced by 25%
Describe the "injury" stage for AKI
- correct answer creatinine x2 & GFR reduced by 50%
,Describe the "failure" stage for AKI
- correct answer creatinine x3 normal, & GFR reduced by 75% (Cant fix)
Describe Prerenal AKI. Give examples.
- correct answer Decreased perfusion to kidneys.
-NSAIDs
-Severe dehydration
-Renal artery stenosis
-MI or HF resulting in low ejection fraction and low cardiac output
-Blood/ fluid loss
Describe Intrarenal AKI. Give examples.
- correct answer Tissue damage to the actual kidneys.
-Glomerulonephritis or inflammation of the glomeruli
-Sepsis
-Intrarenal bleeding
-Pyelonephritis
Describe Postrenal AKI. Give examples.
- correct answer Obstruction that occurs after the kidney.
-Enlarged prostate (BPH)
-Bladder Cancer
-Kidney stones
How do you determine the mean arterial pressure (MAP)?
- correct answer Systolic + (Diastolic*2) /3
, What is the MAP needed to perfuse the kidneys?
- correct answer 65 mmHg
What are examples of nephrotoxic drugs?
- correct answer -NSAIDS
-Metformin
-Diuretics
-Antibiotics (especially -mycin)
-Contrast dye
During the diuretic phase of AKI, what needs to be monitored?
- correct answer Watch for dehydration and make sure output is greater than input
What are the dietary restrictions for an AKI patient?
- correct answer -Low protein
-Low sodium
-Fluid restriction: 1000-1500mL day (for anything except perfusion problem)
What are the 2 most common causes of CKD?
- correct answer -HTN
-Uncontrolled diabetes
What is azotemia?
- correct answer Nitrogenous waste build up
What are manifestations of uremia?
- correct answer •Metallic taste in mouth
•Anorexia
•Nausea/vomiting
•Muscle cramps
•Uremic frost on skin