Pathophysiology of Renal and Urinary Disorders

Comprehensive flashcards covering the pathophysiology, clinical manifestations, diagnostics, and nursing management of renal and urinary conditions including AKI, CKD, PKD, and UTIs.

Acute Tubular Necrosis (ATN)

A type of acute kidney injury caused by ischemia or nephrotoxic injury (e.g., contrast dye, aminoglycosides), resulting in tubular cell death and sloughed cells that obstruct tubules.

Azotemia

An accumulation of nitrogenous waste products in the blood, characterized by $\text{↑ creatinine}$ and $\text{↑ BUN}$, often worsened by the back-leak of filtrate in ATN.

Muddy brown casts

A specific finding in the urine associated with the pathophysiology of Acute Tubular Necrosis.

Bladder scan

A non-invasive assessment tool used to evaluate for urinary retention and measure post-void residual volume.

Timed voiding

A behavioral intervention for clients at risk for urinary retention, typically encouraged every $2-3$ hours.

Pyelonephritis

An infection of the kidneys that can be prevented by hydration, wiping front to back, and voiding after intercourse; major risk factors include untreated UTIs and vesicoureteral reflux.

Renal Calculi

Also known as kidney stones, these are characterized by severe colicky flank pain radiating to the groin, hematuria, and N/V.

Polycystic Kidney Disease (PKD)

A genetic mutation causing cyst formation in the kidneys which enlarge, compress nephrons, and lead to progressive renal failure.

Cerebral aneurysms

A condition related to Polycystic Kidney Disease involving weakened tissue and bulging sacs in the brain vasculature.

Vesicoureteral reflux

A condition where urine flows backward from the bladder to the kidneys, serving as a primary risk factor for pyelonephritis.

Hyperparathyroidism

A metabolic risk factor associated with the formation of renal calculi due to its impact on calcium levels.

KUB

A diagnostic x-ray imaging the kidney, ureter, and bladder used to evaluate urinary retention or stones.

CKD Lab Profile (Elevated)

Includes $\text{↑ BUN}$, $\text{↑ Creatinine}$, $\text{↑ Potassium}$, $\text{↑ Phosphate}$, and albumin.

CKD Lab Profile (Decreased)

Includes $\text{↓ GFR}$, $\text{↓ Calcium}$, and $\text{↓ Hgb/Hct}$.

Metabolic acidosis

The expected acid-base imbalance typically found in clients with Chronic Kidney Disease (CKD).

RAAS activation

A compensatory mechanism in kidney injury leading to vasoconstriction and increased blood pressure.

Fluid Overload Findings

Clinical signs in AKI/CKD including crackles, edema, JVD, hypertension, bounding pulses, and weight gain.

Pruritus in ESRD

Severe itching in end-stage renal disease managed with phosphate binders, moisturizers, cool baths, and antihistamines.

CKD Dietary Restrictions

A diet low in sodium, potassium, and phosphate, with moderate protein and fluid restriction.

Short urethra

An anatomical feature of clients with a vagina that, along with proximity to the anus, increases the risk of bacterial migration and UTIs.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

A home-performed dialysis using the peritoneum as a filter, involving multiple daily exchanges of warmed dialysate.

Cloudy effluent

A clinical finding in peritoneal dialysis that must be reported as it indicates the development of peritonitis.