Risk for CKD - ANSWER Aging population
Fast food
DM
HTN
Obesity
What do the kidneys do? - ANSWER Filter protein, waste products and toxins
Returns vitamins, amino acids
Regulate fluid and electrolyte
Acid/base balance
BP control
RBC production
Maintain bone health
How much fluid/day go through the kidneys? - ANSWER 190 L
How much urine output/day? - ANSWER 2L
How does acid/base balance occur? - ANSWER Elimination and reabsorption
How does BP control take place? - ANSWER Renin angiotensin system
Aldosterone control
1
,How does the RAAS system work? - ANSWER 1. Renin converts angiotensinogen (from
the liver) to angiotensin I
2. Angiotensin I --> angiotensin II (ACE enzyme)
3. Angiotensin II causes vasoconstriction which increases BP and causes release of
aldosterone from adrenal gland
How does aldosterone work? - ANSWER stimulates increased reabsorption of Na+,
which increases water reabsorption and plasma volume
tries to replace volume to get BP up
Secreted to have body make more RBC
secreted in response to? - ANSWER Erythropoietin
Lower O2 level
Why do kidney patients become anemic? - ANSWER Their kidneys cannot secrete
erythropoietin which decreases RBC
How does the kidneys maintain bone health? - ANSWER Kidneys control Vitamin D
activation aids in the absorption of calcium in the intestinal tract
Vitamin D helps our bones absorb calcium keeping our bones strong
A huge problem for renal disease patients - ANSWER Bone health
How do kidneys regulate BP? - ANSWER Vasoconstriction or vasodilation
Increasing circulating blood volume
Renin secreted activating the RAAS
Aldosterone secreted by adrenal gland
Good indicator of how kidneys are functioning
2
,waste from muscle breakdown
normal ranges - ANSWER Creatinine
0.6-1.2
How do we filter creatinine? - ANSWER Through our glomerulus, but we do not
reabsorb through the tubules
If creatinine levels go up - ANSWER there is something wrong with the filter
Creatinine does not increase until.. - ANSWER At least 50% of the kidney function is
lost- and elevation in creatinine should be further assessed
Creatinine can go up a little if... - ANSWER dehydrated, continual going up is usually
decreased GFR
Amount of blood the kidneys can make creatinine free in a minute
Compare ___ and ____ to see how much creatinine is filtering
Blood is collected for 24 hours to do the test
If those numbers go down and we are not filtering out, then our ______ has gone up
Women normal range
Men normal range - ANSWER Creatinine clearance
urine and blood
blood creatinine
87-107
107-239
3
, Measures effectiveness of kidney excretion of urea nitrogen
Reabsorbed- not specific for kidneys- goes up and down when other things are going on -
ANSWER BUN- blood urea nitrogen
Where does urea come from? - ANSWER nitrogenous waste that accumulates in the
body
Breakdown of protein in the liver
makes urea
How do we get rid of urea? - ANSWER Kidney filter urea nitrogen from blood
kidneys excrete the waste in urine elimination
Some days get reabsorbed in the tubules
Will increase w/ tubal disease and glomerular disease
What happens to BUN in dehydration?
what else can cause this? - ANSWER Increases
AKI causes it to increase along with infection, cancer treatment, steroids, tissue injury
Normal BUN - ANSWER 7-21
BUN/creatinine ratio normal range
Tells you where the problem is in the kidneys- helps determine whether non-kidney-related
factors, such as decreased CO or RBC destruction are causing an increase - ANSWER 6-
25
Pre-renal BUN/creatinine ratio - ANSWER Because of BUN reabsorption, BUN
increases faster than creatinine
Deficient fluid volume (dehydration) or decreased CO (BUN is higher than creatinine)
4
Fast food
DM
HTN
Obesity
What do the kidneys do? - ANSWER Filter protein, waste products and toxins
Returns vitamins, amino acids
Regulate fluid and electrolyte
Acid/base balance
BP control
RBC production
Maintain bone health
How much fluid/day go through the kidneys? - ANSWER 190 L
How much urine output/day? - ANSWER 2L
How does acid/base balance occur? - ANSWER Elimination and reabsorption
How does BP control take place? - ANSWER Renin angiotensin system
Aldosterone control
1
,How does the RAAS system work? - ANSWER 1. Renin converts angiotensinogen (from
the liver) to angiotensin I
2. Angiotensin I --> angiotensin II (ACE enzyme)
3. Angiotensin II causes vasoconstriction which increases BP and causes release of
aldosterone from adrenal gland
How does aldosterone work? - ANSWER stimulates increased reabsorption of Na+,
which increases water reabsorption and plasma volume
tries to replace volume to get BP up
Secreted to have body make more RBC
secreted in response to? - ANSWER Erythropoietin
Lower O2 level
Why do kidney patients become anemic? - ANSWER Their kidneys cannot secrete
erythropoietin which decreases RBC
How does the kidneys maintain bone health? - ANSWER Kidneys control Vitamin D
activation aids in the absorption of calcium in the intestinal tract
Vitamin D helps our bones absorb calcium keeping our bones strong
A huge problem for renal disease patients - ANSWER Bone health
How do kidneys regulate BP? - ANSWER Vasoconstriction or vasodilation
Increasing circulating blood volume
Renin secreted activating the RAAS
Aldosterone secreted by adrenal gland
Good indicator of how kidneys are functioning
2
,waste from muscle breakdown
normal ranges - ANSWER Creatinine
0.6-1.2
How do we filter creatinine? - ANSWER Through our glomerulus, but we do not
reabsorb through the tubules
If creatinine levels go up - ANSWER there is something wrong with the filter
Creatinine does not increase until.. - ANSWER At least 50% of the kidney function is
lost- and elevation in creatinine should be further assessed
Creatinine can go up a little if... - ANSWER dehydrated, continual going up is usually
decreased GFR
Amount of blood the kidneys can make creatinine free in a minute
Compare ___ and ____ to see how much creatinine is filtering
Blood is collected for 24 hours to do the test
If those numbers go down and we are not filtering out, then our ______ has gone up
Women normal range
Men normal range - ANSWER Creatinine clearance
urine and blood
blood creatinine
87-107
107-239
3
, Measures effectiveness of kidney excretion of urea nitrogen
Reabsorbed- not specific for kidneys- goes up and down when other things are going on -
ANSWER BUN- blood urea nitrogen
Where does urea come from? - ANSWER nitrogenous waste that accumulates in the
body
Breakdown of protein in the liver
makes urea
How do we get rid of urea? - ANSWER Kidney filter urea nitrogen from blood
kidneys excrete the waste in urine elimination
Some days get reabsorbed in the tubules
Will increase w/ tubal disease and glomerular disease
What happens to BUN in dehydration?
what else can cause this? - ANSWER Increases
AKI causes it to increase along with infection, cancer treatment, steroids, tissue injury
Normal BUN - ANSWER 7-21
BUN/creatinine ratio normal range
Tells you where the problem is in the kidneys- helps determine whether non-kidney-related
factors, such as decreased CO or RBC destruction are causing an increase - ANSWER 6-
25
Pre-renal BUN/creatinine ratio - ANSWER Because of BUN reabsorption, BUN
increases faster than creatinine
Deficient fluid volume (dehydration) or decreased CO (BUN is higher than creatinine)
4
