Chronic Kidney Disease and Related Concepts

These flashcards include key terms and concepts related to chronic kidney disease, its pathology, diagnosis, and implications for treatment.

What should clients with chronic kidney disease avoid unless approved by a provider?

Non-steroidal anti-inflammatory drugs (NSAIDs) due to the risk of kidney damage.

What is the primary difference between chronic kidney disease and acute kidney injury?

CKD involves a subtle decrease in kidney function over at least 3 months, while AKI is a decrease in function that occurs in less than 3 months.

What is the typical GFR for a healthy person?

100-120 mL/min/1.73 m2.

How does hypertension contribute to chronic kidney disease?

It leads to thickening of arterial walls, reducing blood flow and causing ischemic injury.

What is a key mechanism by which diabetes contributes to chronic kidney disease?

Excess glucose in the blood causes non-enzymatic glycation, stiffening the efferent arteriole, leading to hyperfiltration.

What are common symptoms associated with azotemia?

Nausea and loss of appetite.

What is the primary consequence of hyperkalemia in CKD?

Cardiac arrhythmias.

How does CKD affect calcium levels and bone health?

It leads to lowered calcium absorption and increased parathyroid hormone release, resulting in weak bones.

What is the relationship between renin secretion and hypertension in CKD?

Increased renin secretion leads to hypertension, creating a vicious cycle.

How do antihypertensive medications reduce blood pressure via RAAS?

By inhibiting vasoconstriction and water reabsorption.

What initiates the Renin-Angiotensin-Aldosterone System (RAAS) process when blood pressure is low?

Kidneys secrete renin, converting angiotensinogen to Angiotensin I, which is then converted to Angiotensin II.

What are the primary effects of Angiotensin II in the body?

Increases blood pressure by causing vasoconstriction and stimulating aldosterone release.

What common side effect results from ACE inhibitors and what causes it?

Dry cough, caused by the accumulation of bradykinin.

What class of medications blocks Angiotensin II binding to its receptors?

Angiotensin II Receptor Blockers (ARBs).

Which alternative medication class would cause less coughing for a patient on an ACE inhibitor?

Angiotensin II Receptor Blockers (ARBs).

Which medication class is contraindicated during pregnancy due to potential congenital malformations?

All of the above (ACE inhibitors and ARBs).

What laboratory finding is characteristic of stage 4 chronic kidney disease?

Blood potassium 5.0 meq/L.

What kidney function is crucial for blood pressure maintenance?

Regulation of fluid and electrolyte balance.

What is the primary role of the kidneys in medication elimination?

To filter and excrete medications.

What indicates the need for potential dialysis in a CKD patient?

Decreased GFR.

What lab value change is commonly seen in chronic kidney disease?

Increased BUN levels.

Which organ is responsible for urine production?

Kidneys.

How do kidneys contribute to acid-base balance?

By secreting bicarbonate into the bloodstream.

What is polycystic kidney disease (PKD)?

A genetic disorder where kidneys develop fluid-filled cysts.

What is the primary mechanism of cyst growth in PKD?

Abnormal cell proliferation and water transport into the cyst lumen.

What is the inheritance pattern of Autosomal Dominant Polycystic Kidney Disease (ADPKD)?

Dominant.

Which gene is responsible for Autosomal Recessive Polycystic Kidney Disease (ARPKD)?

PKHD1.

What is a severe consequence of renal failure before birth in an ARPKD fetus?

Potter sequence.

What liver condition can occur from congenital hepatic fibrosis in ARPKD?

Portal hypertension.

Which medications treated to manage hypertension in PKD?

ACE inhibitors or ARBs.

Which hormone essential for RBC production is produced by the kidneys?

Erythropoietin.

What characterizes acute kidney injury (AKI)?

A rapid decrease in kidney function, typically over a few days.

Which three main types categorize AKI based on injury cause?

Pre-renal, intra-renal, and post-renal.

What is NOT a function of the kidneys?

Producing digestive enzymes.

What is the most common cause of intra-renal AKI?

Acute tubular necrosis.

What is a characteristic finding in urine of a patient with acute tubular necrosis?

Brown granular casts.

What is a common finding in glomerulonephritis due to increased permeability?

Proteinuria and hematuria.

What is a common early symptom of acute interstitial nephritis?

Eosinophiluria.

What is the typical finding for urine sodium concentration in intra-renal AKI?

Greater than 40 mEq/L.

What does decreased GFR indicate in a CKD client?

The need for potential dialysis.

What does a decreased GFR indicate in kidney function tests?

Reduced kidney function.

What dietary consideration is crucial for clients with PKD?

Low sodium diet.

What part of the urinary system is labeled #3?

Urinary bladder.

What intervention is needed when kidneys are too impaired to function?

Kidney transplant.

What is the expected blood creatinine level in a CKD client?

Elevated above normal.

Why is sodium intake restricted in Clients with CKD?

To reduce blood pressure and fluid overload.

What does a GFR below 15 mL/min/1.73 m2 indicate?

The need for immediate dialysis.

What dietary modification is recommended for stage 2 CKD patients?

Restrict protein intake.

Which medication class must be avoided in pregnant/lactating clients?

ARBs.

What laboratory finding indicates stage 4 CKD?

GFR of 20.

What is acute pyelonephritis?

An inflamed kidney that develops quickly, usually due to a bacterial infection.

What is NOT a risk factor for an upper urinary tract infection (UTI)?

Regular exercise.

What organism frequently causes acute pyelonephritis?

E. Coli.

What systemic symptom distinguishes acute pyelonephritis from lower urinary tract infections?

Flank pain at the costovertebral angle.

What does the term nephrolithiasis refer to?

Kidney stones.

What are alternative terms for kidney stones?

Renal calculi and urolithiasis.

How do kidney stones primarily form in urine?

Solutes precipitating out and crystallizing.

Where else can kidney stones form besides the kidneys?

All of the above (urethra, bladder, ureters).

What electrolyte imbalance is commonly associated with advanced CKD?

Hyperkalemia.

What factors can lead to urinary retention causing kidney damage?

Urinary tract obstruction.

What is the primary purpose of dialysis?

To replace lost kidney function by removing toxic byproducts, waste, and excess fluid.

Which structure is primarily responsible for blood filtration?

Glomerulus.

What condition is an indication for urgent dialysis?

Pulmonary edema unresponsive to conventional treatment.

What action should a nurse avoid when assessing hemodialysis access site?

Measuring BP.

What is an essential step in assessing an AV fistula or graft?

Auscultate for a bruit and palpate for a thrill.

What signs should be reported as potential complications of a hemodialysis access site?

Redness and tenderness around the access site.

What nursing intervention is appropriate for hypotension in a hemodialysis client?

Administer an IV bolus of normal saline.

What instruction is crucial for a client with an AV fistula?

Avoid carrying heavy items or sleeping on the arm with the fistula.

What mechanism primarily triggers the release of renin?

Diminished renal perfusion.

Which process in the body is directly affected by chronic kidney disease?

Fluid and electrolyte imbalance.

What symptom may indicate progression in CKD?

Increased fatigue and weakness.

What dietary consideration is important for CKD patients in preventing progression?

Limiting phosphorus intake.

Why is monitoring potassium levels critical in CKD?

To prevent life-threatening cardiac arrhythmias.

What laboratory test evaluates kidney function?

Serum creatinine level.

What does a high serum creatinine level indicate?

Impaired kidney function.

How does chronic kidney disease affect protein metabolism?

It can lead to protein malnutrition.

What additional health condition is often a concern in CKD?

Hypertension.

Which benefit comes from using angiotensin-converting enzyme inhibitors in CKD?

They help slow the progression of kidney damage.

Why is adherence to prescribed medications crucial for CKD patients?

To manage blood pressure and prevent complications.

What non-pharmacological measure may help manage blood pressure in CKD?

Regular physical activity.

What factor can influence kidney stone formation?

Dehydration.

What imaging technique is commonly used to diagnose kidney stones?

Ultrasound.

What is a common recommendation for patients with history of kidney stones?

Increasing fluid intake.

How do patients with CKD often impact their daily life?

Frequent medical appointments and dietary restrictions.

What type of therapy may a CKD patient require as their condition progresses?

Dialysis or kidney transplantation.

What sign may indicate a possible urinary tract infection in CKD patients?

Increased urge to urinate.

Which mineral's metabolism is significantly affected in CKD patients?

Calcium.

What dietary adjustment may help manage secondary hyperparathyroidism in CKD?

Increased dietary calcium.

What symptom may suggest fluid overload in CKD patients?

Shortness of breath.

How does CKD impact erythropoiesis?

It can lead to anemia due to reduced erythropoietin production.

What is a common psychological impact of chronic illness like CKD?

Depression or anxiety.

What essential counseling should be provided to patients regarding lifestyle?

Smoking cessation is vital.

How can diet modification assist patients with CKD?

It can slow kidney disease progression.

What could excessive protein intake lead to in CKD patients?

Increased urea production and worsening kidney function.

What common electrolyte imbalance occurs due to impaired kidney function?

Increased potassium levels.

In CKD, what risk increases due to the kidneys' inability to filter waste?

Metabolic acidosis.

How does malnutrition affect kidney disease progress?

It can accelerate the decline of kidney function.

What type of examination is crucial for early detection of CKD?

Regular kidney function screenings.

What condition should be monitored closely in patients with diabetes and CKD?

Blood pressure.

What form of preventive care is advised for CKD patients annually?

Vaccinations for the flu and pneumonia.