Introduction to nephrology Flashcards Preview

Kidneys and Hormones > Introduction to nephrology > Flashcards

Flashcards in Introduction to nephrology Deck (42):
1

What vessel supplies the kidney with blood?

Renal artery

2

What vessel drains the kidney with blood?

Renal vein

3

Where does the urine travel?

Down via the ureter to the bladder

4

What are the units that make up the kidney called?

Nephrons

5

How does the renal artery divide?

Renal artery -> capillary loop -> glomerulus

6

The capillary walls are specialised for transport of fluid and salt

TRUE or FALSE

True

7

Where does the fluid collect once it is filtered in the glomerulus?

In the Bowman's Capsule

8

How many litres of blood are filtered a day?

180 L

9

How many litres of urine are produced a day?

2 L

10

Everyone starts with the same number of nephrons

TRUE or FALSE

FALSE

Not everyone starts with the same number of nephrons

Danish adults have less mean number of nephrons than Americans and Australians

11

What difference does nephron number make in the health of a kidney?

Nephron number accounts for differences in susceptibility to kidney disease

Premature babies = less nephrons and higher susceptibility to hypertension/ renal disease

12

What are the functions of the kidney?

Salt and water regulation

Maintains acid-base balance

Synthesises EPO

Activates vitamin D

13

Why is it important to regulate salt and water in the blood?

Maintains blood pressure

14

How do the kidneys maintain acid-base balance?

Absorbs and secretes electrolytes/ salts/ sugars

15

What is the role of EPO?

Stimulates RBC production

16

What does vitamin D regulate?

Calcium and phosphate concentration

17

What are methods by which we can measure kidney function?

Clearance of compounds

Filtration of water and electrolytes

Concentration of macromolecules in the urine

Production of vitamin D/ EPO

18

Whic compounds can we use to measure the clearance by the kidneys?

Urea and serum creatinine

19

What is creatinine?

Molecules formed by the breakdown of creatinine phosphate in the muscle

Produced at a constant rate by the body

Excreted unchanged by the kidneys

20

Why is measuring the filtration of water or electrolytes not practical to determine kidney function?

Have to collect urine over time to eradicate minute to minute alterations

21

Why is measuring the concentration of macromolecules in the urine a good way to determine kindey function?

A healthy filtration barrier should not let macromolecules pass through

22

What are examples of macromolecules?

Proteins

RBC

23

What are the 2 ways in which production of vitamin D or EPO can be measured in the blood?

Measure directly in blood

Can also measure indirectly - calcium phosphate balance or RBC count

24

Do men or women have higher GFR?

Men

Higher muscle mass - higher GFR needed

25

Do old or young people have higher GFR?

Young

Have higher muscle mass

26

What is the relationship between GFR and serum creatinine?

Non-linear relationship

Large change in GFR leads to a small change in serum creatinine

Large change in serum creatinine leads to a small change in GFR

27

How does renal function change with age?

GFR declines as we age - scarring of kidneys over time

Decline in GFR isn't enough to lead to kidney disease

28

What is the average decline of GFR as we age?

0.4 ml/min/1.73m2

29

What are the symptoms of kindey failure?

Dirty blood - inadequate filtration

Fluid accumulation

High blood pressure

Anaemia

Bone disease

Lipid abnormalities

30

Why does fluid accumulate in kidney disease?

Acid-base balance is disrupted

Oncotic pressure is created

Causes water to build up in body tissues

31

Why does kidney disease lead to anaemia?

Imbalance in EPO synthesis

32

Why does kidney disease lead to bone disease?

Bones attempt to maintain serum calcium levels

Bone resorption = osteomalacia

33

Why does kidney disease lead to lipid abnormalities?

Disruption in the metabolism of lipids

34

What is the difference between acute and chronic kidney disease?

Acute - sudden loss of kidney function

Chronic - level of function is reduced but patients maintain health

35

Patients with CKD often maintain health

TRUE or FALSE

True

36

What are causes of kidney dysfunction?

Developmental/ genetic - may not grow normally, malformed

Acquired problems

37

What are examples of acquired problems that lead to kidney disease?

Blood supply problems

Blockage of urinary flow

Diseases (systemic or kidney-specific) that interfere with nephron function

38

What are the treatments of kidney disease?

If drug toxicity or infection - treat underlying cause

If immunological disease - immunosuppression

39

What can be done to slow down the progression of CKD?

Controlling blood pressure

This makes sure funcitoning nephrons last longer

40

What happens if you can't treat the underlying cause of kidney disease?

Patient may develop end-stage kindey failure

41

What are the treatments for end-stage kindey failure?

Transplant

Maintenance hemodialysis - replaces kidney function

42

Why should we care about kidney disease?

Affects up to 3 million people in the UK

Increasing due to increases in disease - diabetes, aging population

Dysfunction is often unknown due to few symptoms