lOMoAR cPSD| 67691079
Introduction to Chronic Kidney
Disease
Chronic kidney disease (CKD), or a glomerular filtration rate of less than 60
for more than three months, is a loss of kidney function related to comorbid
conditions such as diabetes or hypertension. As more kidney damage occurs,
other organ systems also become impacted. Therefore, prompt identification,
treatment, and protection are necessary to produce optimal healthcare
outcomes.
Acid-Base Imbalance
Which acid-base imbalance is associated with altered urinary elimination due
to chronic kidney disease (CKD)?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Altered Urinary Elimination
Which of the following diagnoses can alter urinary elimination? Select all that
apply.
Benign prostatic hyperplasia
Coronary artery disease
Pyelonephritis
Chronic kidney disease
, lOMoAR cPSD| 67691079
Group A streptococcus
Viral meningitis
Fluid Regulation
Which of the following statements correctly reflects the pathophysiology
associated with fluid regulation? Select all that apply.
Aldosterone hormone motions the kidneys to reabsorb sodium and water.
Vasopressin stimulates the kidneys to excrete more water.
Antidiuretic hormone signals the kidneys to reabsorb water.
B-type natriuretic protein causes kidneys to excrete more sodium and water.
Oxytocin hormone causes the kidneys to retain sodium.
Normal and Abnormal Kidney
Physiology
Healthy Kidney Function
The healthy kidney performs several vital functions to maintain the body's internal environment.
Click each section below to learn more about these vital functions.
Fluid Homeostasis
Fluids in the body are stored in compartments. Two-thirds of the body’s fluids
are intracellular (within the cells in the body). One-third of the fluid in the body
is extracellular (outside of the cell). Extracellular fluids include interstitial
(outside the cells and the vascular system), intravascular (within blood
vessels), and other compartments (cerebrospinal areas).
, lOMoAR cPSD| 67691079
Fluid imbalances occur when these fluids shift from one compartment to
another, causing an excess or deficit of fluid needed in each compartment to
maintain homeostasis. Separated by semipermeable cellular membranes and
blood vessel walls, fluid can move between spaces through hydrostatic and
osmotic pressure. In the vascular system, osmotic and hydrostatic pressure
work opposite to control fluid movement between the blood and interstitial
areas. Increased hydrostatic pressure causes fluid to move out of the vascular
system, and increased osmotic pressure draws fluid back into the blood. When
pathophysiologic conditions occur, various hormones, protein levels, and
pressure changes alter the balance to maintain fluid homeostasis.
Normal Physiology of Fluid Regulation
Electrolytes, blood pressure, proteins, and certain hormones drive fluid
movement and overall regulation. The body uses these homeostatic
mechanisms to move fluids from one compartment to another, compensating
for fluid imbalance. Abnormalities in any of the following mechanisms can
cause fluid imbalance in clients with chronic kidney disease. The
homeostatic mechanisms of fluid regulation include the following:
● Electrolytes adjust fluid levels. For example, the renal system utilizes
sodium to transport fluid to the urinary system or to retain fluid within the
vascular system when the body detects a shortage in fluid volume.
● Blood vessels constrict or dilate to regulate blood pressure. Receptors
send signals to the autonomic nervous system depending on alterations
in fluid balance.
● Proteins maintain fluid balance by attracting water. Low protein levels
can cause the movement of fluid into interstitial areas, causing edema.
Too much protein (proteinuria) can be lost from the blood and excreted
into the urine (e.g., nephrotic syndrome), causing damage to the filtering
part of the kidneys. Proteinuria over time may be the first sign that
kidney disease or another condition has damaged the filters in the
kidneys.
● Hormones attract fluid or control the pressure of the vascular system.
For example, renin, a hormone made by the kidney, is converted to
angiotensinogen to cause vasoconstriction. It also stimulates
aldosterone production by the adrenal gland, which retains fluid in the
vascular system. The most compensatory hormones include the
following:
○ Antidiuretic hormone (ADH): ADH signals the kidneys to promote
reabsorption of water.
Introduction to Chronic Kidney
Disease
Chronic kidney disease (CKD), or a glomerular filtration rate of less than 60
for more than three months, is a loss of kidney function related to comorbid
conditions such as diabetes or hypertension. As more kidney damage occurs,
other organ systems also become impacted. Therefore, prompt identification,
treatment, and protection are necessary to produce optimal healthcare
outcomes.
Acid-Base Imbalance
Which acid-base imbalance is associated with altered urinary elimination due
to chronic kidney disease (CKD)?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Altered Urinary Elimination
Which of the following diagnoses can alter urinary elimination? Select all that
apply.
Benign prostatic hyperplasia
Coronary artery disease
Pyelonephritis
Chronic kidney disease
, lOMoAR cPSD| 67691079
Group A streptococcus
Viral meningitis
Fluid Regulation
Which of the following statements correctly reflects the pathophysiology
associated with fluid regulation? Select all that apply.
Aldosterone hormone motions the kidneys to reabsorb sodium and water.
Vasopressin stimulates the kidneys to excrete more water.
Antidiuretic hormone signals the kidneys to reabsorb water.
B-type natriuretic protein causes kidneys to excrete more sodium and water.
Oxytocin hormone causes the kidneys to retain sodium.
Normal and Abnormal Kidney
Physiology
Healthy Kidney Function
The healthy kidney performs several vital functions to maintain the body's internal environment.
Click each section below to learn more about these vital functions.
Fluid Homeostasis
Fluids in the body are stored in compartments. Two-thirds of the body’s fluids
are intracellular (within the cells in the body). One-third of the fluid in the body
is extracellular (outside of the cell). Extracellular fluids include interstitial
(outside the cells and the vascular system), intravascular (within blood
vessels), and other compartments (cerebrospinal areas).
, lOMoAR cPSD| 67691079
Fluid imbalances occur when these fluids shift from one compartment to
another, causing an excess or deficit of fluid needed in each compartment to
maintain homeostasis. Separated by semipermeable cellular membranes and
blood vessel walls, fluid can move between spaces through hydrostatic and
osmotic pressure. In the vascular system, osmotic and hydrostatic pressure
work opposite to control fluid movement between the blood and interstitial
areas. Increased hydrostatic pressure causes fluid to move out of the vascular
system, and increased osmotic pressure draws fluid back into the blood. When
pathophysiologic conditions occur, various hormones, protein levels, and
pressure changes alter the balance to maintain fluid homeostasis.
Normal Physiology of Fluid Regulation
Electrolytes, blood pressure, proteins, and certain hormones drive fluid
movement and overall regulation. The body uses these homeostatic
mechanisms to move fluids from one compartment to another, compensating
for fluid imbalance. Abnormalities in any of the following mechanisms can
cause fluid imbalance in clients with chronic kidney disease. The
homeostatic mechanisms of fluid regulation include the following:
● Electrolytes adjust fluid levels. For example, the renal system utilizes
sodium to transport fluid to the urinary system or to retain fluid within the
vascular system when the body detects a shortage in fluid volume.
● Blood vessels constrict or dilate to regulate blood pressure. Receptors
send signals to the autonomic nervous system depending on alterations
in fluid balance.
● Proteins maintain fluid balance by attracting water. Low protein levels
can cause the movement of fluid into interstitial areas, causing edema.
Too much protein (proteinuria) can be lost from the blood and excreted
into the urine (e.g., nephrotic syndrome), causing damage to the filtering
part of the kidneys. Proteinuria over time may be the first sign that
kidney disease or another condition has damaged the filters in the
kidneys.
● Hormones attract fluid or control the pressure of the vascular system.
For example, renin, a hormone made by the kidney, is converted to
angiotensinogen to cause vasoconstriction. It also stimulates
aldosterone production by the adrenal gland, which retains fluid in the
vascular system. The most compensatory hormones include the
following:
○ Antidiuretic hormone (ADH): ADH signals the kidneys to promote
reabsorption of water.
