1 / 16

Diseases of the Kidney

Learn about kidney function, kidney diseases, and related definitions such as renal filtrate and GFR. Explore the consequences and dietary management of nephrotic syndrome, causes of renal failure, assessment methods, treatment options like dialysis, and medication for kidney-related issues.

tgreenawalt
Download Presentation

Diseases of the Kidney

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Diseases of the Kidney Kidney Physiology Kidney Functions: • activate vitamin D (renal 1-alpha hydroxylase) • produces erythropoietin which stimulates RBC formation • helps regulate blood pressure • ELIMINATES METABOLIC WASTE PRODUCTS • HELPS MAINTAIN FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES

  2. Kidney Diseases of Note • Glomerulonephritis (acute or chronic) • Nephrotic Syndrome • Acute Renal Failure • Chronic Renal Failure • Dialysis • Urinary Calculi

  3. A Few Definitions Renal Filtrate: fluid from the blood filtered by the kidneys that forms urine. GFR: Glomerular Filtration Rate the rate at which the kidney forms renal filtrate. Normal: 90-120 ml/min Renin: enzyme secreted by kidney in response to low blood flow; results in adrenal signal (aldosterone) to cause kidney to retain Na and water.

  4. A Few More Definitions Nephrotic Syndrome: a cluster of symptoms • proteinuria • low serum albumin • edema • hyperlipidemia Sometimes an early sign of renal failure. Caused by: infections, certain drugs, toxins, DM, renal blood clots.

  5. Consequences of Nephrotic Syndrome Proteinuria Albumin Immunoglobulins (immunity) Transferrin (anemia) Vitamin D-BP (rickets) Low serum proteins fluid shift into interstitial spaces Low Blood Volume Edema Kidneys Respond Retain Na and fluids!!!!

  6. Diet in Nephrotic Syndrome Energy: 35 kcal/ kg Protein: 0.8-1.0 g / kg Fat: < 30% of kcals; low in saturated fatty acids. Sodium: During edematous phase 250 mg/day As edema resolves to ~ 1500 mg/ day

  7. Prerenal Postrenal Intrarenal LOW RENAL OBSTRUCTION KIDNEY DAMAGE BLOOD FLOW IN URINARY TRACT Acute Renal Failure SUDDEN PRECIPITOUS DROP IN GFR, URINE OUTPUT

  8. DEFINITIONS: KIDNEY FAILURE UREMIA/ AZOTEMIA: Build-up of urea nitrogen in the blood (BUN). Normal: 10-20 mg/dl Uremia: 50-150 mg/dl ESRD: 150-250 mg/dl ARF Phases: 1. Oliguric= reduced urine volume; 2. Diuretic= large fluid/electrolyte losses; 3. Recovery= NL renal function

  9. Uremic Syndrome Build-up of toxic waste products in the blood (e.g., urea, potassium) Symptoms: Weakness, Fatigue “Dull” mental state Anorexia, N/V/D, altered taste, subdermal hemorraging

  10. Causes of Chronic Renal Failure • Diabetic or HIV-Related Nephropathy • Recurrent Glomerulonephritis or Pyelonephritis • Acute Non-Responsive Kidney Failure • Nephrosclerosis • Cardiac Failure • Extensive Atherosclerosis • Malignant Hypertension

  11. Early & Accurate Assessment • Anthropometrics (< 20 BMI or < 80% body weight • Biochemistry (albumin, prealbumin, cholesterol, K, creatinine, BUN) • Clinical Assessment (edema, GIT) • Dietary Intake( protein, calories, K, PO4)

  12. Without Adequate Protein/ Kcals: Hypermetabolic state= Break down visceral protein stores; Hyperkalemia worsens. Kcal needs: 30-50 kcal/kg (depending on level of catabolism) Oliguric phase: Diuretics, restrict fluids, Na and K. Diuretic phase: Fluids and K supplements

  13. Measuring fluid needs: Measure urinary output, then add 500 ml for insensible losses.

  14. Protein Needs in ARF Non-Dialyzed Pts Dialyzed Pts 0.6 to 1.0 g/ kg 1.1-2.5 g/ kg Feeding in Enteral and Parenterally-Fed Patients Less Protein, Electrolytes Lower amino acid [ ] High Kcal Density Higher Dextrose [ ] Insulin may be used to control hyperglycemia

  15. Medications • Hyperkalemia - Exchange resins (po or enema) • e.g.polystyrene sulfonate to increase fecal • potassium losses by exchanging sodium. • Hyperphosphatemia - Phospate binders e.g. • Phosphlo & Tums (Ca based); Magnabid (Mg • based); Amphogel (Al based); Renagel (polymer) • Anemia - Iron • Edema - Diuretics

  16. Dialysis Removal of blood waste products through a semi-permeable membrane via diffusion/osmosis. Hemodialysis Large blood vessel tapped,blood routed through dialysis machine, excess fluid/ electrolytes are removed. Dialysed blood returned to body. Peritoneal Dialysis Dialysis is accomplished using peritoneal cavity as the semi-permeable membrane.

More Related