CCU Renal - Renal Failure + Dialysis Master Deck

Vocabulary flashcards reviewing core concepts, laboratory values, complications, and nursing interventions related to renal failure, acute kidney injury (AKI), and dialysis modalities.

Renal Failure

A condition in which the kidneys are not functioning properly.

BUN and Creatinine

The two nitrogenous waste markers commonly assessed to evaluate renal function, with a normal ratio of approximately $5-20:1$.

Acute Kidney Injury (AKI)

The modern term for acute renal failure, which develops relatively quickly, typically over a few days.

Chronic Kidney Disease (CKD)

The modern term for chronic kidney failure, involving decreased kidney function for at least $3\text{ months}$.

Oliguria

A clinical term meaning decreased urine output.

Anuria

A clinical term meaning essentially absent urine output.

Uremia

The clinical condition caused by the accumulation of uremic toxins in renal failure.

Prerenal AKI

AKI caused by decreased renal perfusion/blood flow to the kidneys, leading to decreased GFR without initial structural kidney damage.

Prerenal Profile

Laboratory profile characterized by BUN:Cr $>20:1$, urine $Na^+ < 20(mEq/L)$, FENa $<1\%$, and urine osmolality $>500(mOsm/kg)$.

Intrarenal (Intrinsic) AKI

AKI caused by structural damage within the kidney, specifically affecting the tubules, glomeruli, or renal interstitium.

Intrarenal Profile

Laboratory profile characterized by BUN:Cr $<20:1$, urine $Na^+ > 40(mEq/L)$, FENa $>2\%$, and urine osmolality $<350(mOsm/kg)$.

Acute Tubular Necrosis (ATN)

The most common cause of intrarenal AKI, defined by injury and death of renal tubular epithelial cells, often resulting from ischemia or nephrotoxins.

ATN Susceptible Segments

The proximal tubule and thick ascending limb, which are particularly vulnerable to ischemic injury in acute tubular necrosis.

Myoglobin

A pigment/protein released during rhabdomyolysis that can cause acute tubular necrosis (ATN).

Acute Interstitial Nephritis (AIN)

An intrinsic renal process suspected when a patient presents with NSAID exposure accompanied by fever, rash, and AKI.

Asterixis

A flapping tremor of the hands seen when the wrists are extended, which may occur with uremic encephalopathy.

Uremic Pericarditis

Inflammation of the pericardium associated with severe uremia.

AEIOU Mnemonic

Mnemonic for urgent dialysis indications: Acidosis, Electrolyte problems (refractory hyperkalemia), Intoxications, Overload (refractory fluid overload), and Uremic complications.

Dialysis

A kidney replacement therapy that removes metabolic wastes and excess fluid while helping correct electrolyte and acid–base imbalances.

Hemodialysis

A type of dialysis that circulates blood through an external dialyzer/artificial kidney.

Peritoneal Dialysis

A type of dialysis that utilizes the patient's own peritoneal membrane as the semipermeable membrane for fluid and solute exchange.

Dialyzer

The semipermeable membrane filter (artificial kidney) used in hemodialysis.

Ultrafiltration

The removal of water across a membrane driven by a pressure gradient during dialysis.

Dialysate

The solution used in dialysis to facilitate the exchange of solutes and fluid.

AV Fistula

The preferred long-term permanent hemodialysis access created by surgically connecting the patient's own artery and vein.

Thrill and Bruit

Clinical indications of blood flow through a dialysis access: a thrill is the palpable vibration, and a bruit is the audible sound.

Dry Weight

The target post-dialysis weight at which excess fluid has been removed without inducing signs of hypovolemia or hypervolemia.

Dialysis Disequilibrium Syndrome (DDS)

A neurologic complication that can develop when solutes are removed too rapidly during dialysis.

Peritonitis

The major infectious complication of peritoneal dialysis, typically presenting with cloudy dialysate effluent, abdominal pain/tenderness, and fever.

Erythropoietin (EPO)

A hormone produced by the kidneys that stimulates red blood cell production.

Glomerulus

The capillary network in the nephron where blood filtration primarily occurs.

Renin–Angiotensin–Aldosterone System (RAAS)

The hormonal cascade activated by decreased renal perfusion, leading to aldosterone release and subsequent renal reabsorption of sodium ($Na^+$) and water.

Cardiorenal Syndrome

A condition in which severe systolic heart failure leads to reduced effective renal perfusion and acute kidney dysfunction.

Diffusion

The movement of solutes across a semipermeable membrane from an area of higher concentration to an area of lower concentration.

Intradialytic Hypotension

A common complication occurring during dialysis as a result of rapid fluid removal, manifested by dizziness, nausea, cramping, and low blood pressure.