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RENAL

CCRN

QuestionAnswer
How does the kidney maintain perfusion? AFFERENT ARTERIOLAR DILATION AND EFFERENT ARTERIOLAR CONSTRICTION
Fluid is forced from the glomerulus, forming an ultrafiltrate. Into which compartment is the fluid forced? PROXIMAL TUBULE
Which element is not filtered during glomerular filtration? PROTEINS
Cortex The outer one third of the kidney tissue, consisting of the glomeruli, nephrons and the convoluted portions of the distal and proximal tubules.
Medulla The inner portion of the kidney. It contains the loop of Henle, vasa recta, and the collecting ducts.
Nephron The functional unit of the kidney.
Glomerulus A network of capillaries that are formed by the afferent arterioles
The normal adult urine volume is 1 to 2 L/day
The total glomeruli filter is 180L/day
Loop of Henle Function to concentrate or dilute urine as necessary.
Serum osmolarity to Normal level 280 to 320
Countercurrent Mechanism Serves to concentrate urine and excrete excessive solutes.
BUN Measures the level of urea. Normal level 10 to 20mg/dL
Creatinine A waste product of muscle metabolism and is freely filtered. Normal serum level .8 to 1.8 mg/dL
BUN TO CREATININE RATIO (serum) Normal 10:1 A ratio of 20:1 or more in indicative of prerenal insufficiency (water and salt depletion).
Creatinine clearance Probably the most reliable index of kidney function available. Normal is 125mL/min.
Aldosterone Maintain normal sodium concentration in the extracellular fluid. Promotes reabsorption of sodium in both the distal convoluted tubule and the collecting ducts of the kidneys.
Angiotesin II A potent vasoconstricting agent.
Prostaglandins Promote a vasodilatin of the renal medulla to maintain renal perfusion during severe or prolonged systemic hypoperfusion.
Oliguria less than 400mL of urine is produced per day.
Prerenal acute renal failure A decrease renal perfusion secondary to renal hypoperfusion, often due to decreased cardiac output
Intrarenal acute renal failure Caused by disease or injuries of the nephron from the glomerulus to the collecting duct. The most common cause is acute tubular necrosis.
Postrenal acute renal failure Indicates an intra or extrarenal obstruction at or below the level of the collecting ducts.
What are the four phases of acute renal failure? ONSET, OLIGURIC, DIURETIC AND RECOVERY
Normal urine volume .5 mL/kg/h
What is the normal range of urine sodium values? 40 to 220 meq/L
Creatinine level is a valuable indicator of glomerular filtration rate for which reason? Once filtered in the glomerulus, creatinine is not reabsorbed in the tubular system.
Most water reabsorption occurs in which part of the nephron? PROXIMAL TUBULES
the presence of oliguria, a BUN/creatinine ratio greater than normal suggests that which condition has developed? PRERENAL FAILURE
Aldosterone exerts an effect on renal function at which anatomic site? DISTAL TUBULE
The juxtaglomerular system is responsible for releasing which substance? ANGIOTENSIN
Which electrolyte is directly related to the reabsorption of magnesium? SODIUM
Hypomagnesemia is manifested clinically by which of the following symptoms? MUSCLE IRRITABILITY
Elevated chloride levels are associated with which condition? ALKALOSIS
Left ventricular failure will cause which effect on the BUN/creatinine ratio? It will cause the ratio to rise. (BUN rises faster than creatinine.)
What is the clinical value in establishing wheter or not an anion gap exists? The finding permits determination of a metabolic acidosis.
Measurement of what is helpful in differentiating ARF from prerenal azotemia? FENa
FENa (fractional excretion of sodium FENa is > than 1% and usually > than 3% wit ATN n severe obstruction of the urinary drainage of both kidneys. It is generally < than 1% in pts with acute glomerulonephritis, hepatorenal syndrome, and states of prerenal azotemia such as CHF or dehydration.
What are the indications for continuous arteriovenous hemofitration? 1. Treating acute volume oveload in CHF. 2. FLUID REMOVAL WHEN DIURETIC THERAPY HAS FAILED. 3. ACUTE HYPERKALEMIA
Renal trauma is best diagnosed by. INTRAVENOUS PYELOGRAM
UREMIC SYNDROME Results fromthe kidney's inability to excrete toxic waste products.
Created by: nerdismart