Renal Diseases

what is acute kidney injury

sudden, temporary loss of function

can be caused by drugs or dehydration

what is the BUN/SCr ratio for dehydration

BUN/SCr >20:1

what is chronic kidney disease

progressive loss of function

measured by GFR or CrCl and degree of albuminuria

what is end stage renal disease

total, permanent kidney failure

fluid and waste accumulate

requires dialysis or a transplant

what is the functional unit of the kidney

nephron

what is the filtering unit

glomerulus

what supplies blood to the glomerulus

afferent arteriole

what removes blood from the glomerulus

efferent arteriole

what does filtrate (urine) pass through

proximal tubule

what is removed from the proximal tubule

small substances

in CKD large things like albumin are removed

where do most substances get reabosorbed?

proximal tubule

what does the ascending limb reabsorb

sodium and chloride

what does the descending limb reabsorb

water

where do loop diuretics work

ascending limb

what do loop diuretics inhibit

Na-K pump to decrease sodium reabsorption

where do thiazide diuretics work

distal convoluted tubule

what do thiazide inhibit

Na-Cl pump, increasing calcium that is reabsorbed

where do aldosterone antagonists work

distal convoluted tubule and collecting duct

how do aldosterone antagonist work

decreases sodium and water reabsorption and increases potassium reabsorption

what are risk factors for drug induced kidney disease

using multiple nephrotoxic medications

having pre-existing kidney disease

having decreased kidney blood flow

being elderly

what drugs cause kidney disease

aminoglycosides

amphoteracin b

cisplatin

cyclosporine

loop diuretics

NSAIDs

polymyxins

radiographic contrast dye

tacrolimus

vancomycin

what should be first line treatment to prevent progression of CKD

ACEs/ARBs