Urinary Conditions & Procedures

What is acute cystitis?

An infection of the bladder commonly caused by E coli.

How do bacteria reach the urinary tract in acute cystitis?

They gain access from the urethra.

What symptoms are associated with acute cystitis?

Frequency, urgency, dysuria, and sometimes hematuria.

What is urinary frequency?

Frequent need to urinate.

What is urinary urgency?

An urgent feeling of the need to void.

What is dysuria?

Painful or difficult urination.

How is acute cystitis diagnosed?

Urinalysis and urine culture and sensitivity.

How is acute cystitis treated?

A short course of antibiotics.

What is acute pyelonephritis?

Inflammation of the kidney and renal pelvis caused by kidney infection.

Where does acute pyelonephritis infection usually come from?

It ascends from the lower urinary tract.

What symptoms can occur with acute pyelonephritis?

Fever, tachycardia, flank pain, shaking chills, voiding symptoms, nausea, vomiting, and diarrhea.

How is acute pyelonephritis diagnosed?

Urinalysis, urine culture, and renal ultrasound or CT scan.

What can untreated acute pyelonephritis lead to?

Sepsis and shock.

How is acute pyelonephritis typically treated?

Hospitalization for IV antibiotics and IV fluids.

What is acute kidney injury (AKI)?

Worsening kidney function over a short period, specifically hours to days.

What is azotemia or uremia in AKI?

Accumulation of waste products in the bloodstream.

What symptoms can uremia cause?

Changes in mental status, nausea, vomiting, and malaise.

What are the three classifications of AKI?

Prerenal, intrinsic kidney disease, and postrenal.

What causes prerenal AKI?

Decreased perfusion of the kidney with blood.

What can cause decreased kidney perfusion?

Decreased cardiac output, blood loss or GI losses, or excessive diuretic use.

What intrinsic kidney diseases can lead to AKI?

Acute tubular necrosis, acute glomerulonephritis, and interstitial nephritis.

What can cause postrenal AKI?

Obstruction of the urethra, bladder, or one or both ureters.

How is AKI treated?

By treating the underlying cause.

What can untreated AKI lead to?

Chronic kidney disease.

What is chronic kidney disease (CKD)?

Decline in kidney function over months to years; also called chronic renal failure.

What conditions are associated with most CKD cases?

Hypertension and/or diabetes mellitus.

When do CKD symptoms usually develop?

In the later stages of renal failure.

What symptoms are associated with uremic syndrome in CKD?

Nausea, vomiting, fatigue, anorexia, and a metal taste in the mouth.

What other symptoms can occur with CKD?

Puritis, restless legs, insomnia, and difficulty with memory.

What complications of CKD are listed?

Hypertension, anemia, hyperkalemia, heart failure, atrial fibrillation, and coronary artery disease.

What are treatment goals for CKD?

Slow renal failure progression and treat diabetes mellitus and hypertension.

What treatments are used for severe CKD?

Dialysis and renal transplant.

What is dialysis?

A procedure that separates waste from blood and maintains normal fluid, electrolyte, and acid-base balance.

What are the two types of dialysis?

Hemodialysis and peritoneal dialysis.

What is an arteriovenous fistula?

A surgically created connection of an artery and vein used for hemodialysis.

How does hemodialysis work?

Blood is removed, processed through a dialyzer, and returned to the body.

How does peritoneal dialysis work?

Dialysate enters the peritoneal cavity, the peritoneal membrane filters the blood, and the fluid is then removed and replaced.

What is an advantage of peritoneal dialysis?

It can be completed at home.

What is a common complication of peritoneal dialysis?

Peritonitis, inflammation of the peritoneal membrane.

What is renal transplantation?

A living or deceased donor kidney is surgically placed into a patient with CKD.

What is nephrolithiasis?

Urinary stone disease; development of stones within the urinary tract.

How common is urinary stone disease according to the module?

It affects 1 in 11 Americans each year.

What is the most common type of urinary stone listed?

A calcium oxalate or phosphate stone.

What factors are associated with renal calculi?

Medications, inadequate hydration, family history, and living in hot and humid environments.

When do renal stones cause symptoms?

When they obstruct the flow of urine from the kidney.

What symptoms can renal calculi cause?

Sudden severe flank pain, nausea, vomiting, and difficulty finding a comfortable position.

How can renal stone pain change as the stone moves?

The pain may move as the stone progresses through the urinary system.

What is extracorporeal shockwave lithotripsy?

A procedure that breaks up a ureteral stone to allow it to pass.

What is ureteroscopic stone extraction?

A scope travels to the site of the stone for removal.

What is percutaneous nephrolithotomy?

A scope inserted through the back breaks up and removes a stone from the renal pelvis.