Renal and Metabolic Diseases - Unit 1 Notes

A comprehensive set of vocabulary flashcards covering acute and chronic renal failure, renal colic, and metabolic disorders discussed in unit 1.

Acute renal failure (ARF)

Sudden onset decrease in kidney function with a drop in GFR, commonly due to prerenal (decreased renal blood flow), intrinsic renal damage (glomerulus/tubules/vasculature), or postrenal obstruction.

Prerenal ARF

Acute renal failure caused by decreased renal perfusion such as hemorrhage, burns, vomiting, or decreased cardiac output.

Renal (intrinsic) ARF

Acute kidney injury due to damage within the kidney itself (glomerulus, tubules, or vascular disease).

Postrenal ARF

Acute renal failure due to obstruction of urine flow (e.g., crystals, drugs, neoplasms).

Chronic kidney disease (CKD)

Progressive loss of renal function for more than three months with kidney damage; proteinuria is a big marker; common etiologies include diabetes, hypertension, glomerulonephritis, and polycystic kidney disease.

Proteinuria

Presence of excess protein in urine; a key marker of kidney damage, especially in CKD.

End-stage renal disease (ESRD)

Final stage of CKD where dialysis or kidney transplant is required for survival.

Glomerular filtration rate (GFR)

A test to determine how well the kidneys are functioning and how much blood is filtered by the glomeruli; used to stage kidney disease and influenced by creatinine, age, gender, race, and body size.

GFR stages (1–5)

A staging system for kidney disease based on GFR; stage 5 represents kidney failure.

Diabetes mellitus as CKD etiology

A top cause of CKD due to long-standing hyperglycemia damaging renal tissue.

Hypertension as CKD etiology

High blood pressure contributing to kidney damage and CKD progression.

Glomerulonephritis as CKD etiology

Inflammation of the glomeruli contributing to chronic kidney disease.

Polycystic kidney disease

Inherited condition with kidney cysts that damage renal tissue over time, leading to CKD.

Cystinosis

Amino acid metabolism disorder with cysteine accumulation in lysosomes; causes inability to concentrate or acidify urine and progressive renal damage.

Cystinuria

Tubular reabsorption defect of cystine and other dibasic amino acids leading to cystine stones and recurrent UTIs.

Maple syrup urine disease (MSUD)

Defect in breakdown of branched-chain amino acids (leucine, isoleucine, valine); causes failure to thrive, ketoacidosis, maple-syrup odor in urine; treated with dietary restrictions.

Phenylketonuria (PKU)

Deficiency of phenylalanine hydroxylase causing phenylalanine buildup and excretion of phenylpyruvic acid; symptoms include delayed development and mousy urine odor; newborn screening is used.

Alkaptonuria

Deficiency of homogentisic acid oxidase causing accumulation of homogentisic acid; urine darkens on standing; pigmentation of skin; managed with vitamin C.

Tyrosinuria

Excess tyrosine in urine due to defective tyrosine metabolism; tyrosine crystals may appear; diet management is used.

Diabetes mellitus

Group of carbohydrate metabolism disorders with type 1 (autoimmune insulin deficiency) and type 2 (insulin resistance); features include hyperglycemia, glucosuria, polyuria, polydipsia, weight loss, and risk of ketoacidosis.

Type 1 diabetes mellitus

Autoimmune destruction of pancreatic beta cells leading to insulin deficiency and potential ketoacidosis; typically younger onset.

Type 2 diabetes mellitus

Insulin resistance or impaired insulin action; often adult-onset; may be non–insulin-dependent but can progress to needing insulin.

Diabetes insipidus

Disorder with dilute urine due to problems with ADH; two types: neurogenic (central) with reduced ADH, and nephrogenic with renal insensitivity to ADH.

Neurogenic (central) diabetes insipidus

Decreased production or release of ADH from the hypothalamus/pituitary.

Nephrogenic diabetes insipidus

Kidneys do not respond to ADH despite normal levels of the hormone.

Galactosemia/galactosuria

Defect in galactose metabolism causing galactose accumulation in blood and urine; symptoms include failure to thrive, diarrhea, vomiting, liver dysfunction; newborn screening; Clinitest positive with glucose dipstick negative.

Clinitest

Urine reducing-substance test; positive in galactosemia indicating galactose presence even if glucose dipstick is negative.

Diabetic ketoacidosis (DKA)

Serious complication of diabetes with high ketone production causing metabolic acidosis; often triggered by infection; common in type 1; symptoms include fruity breath, polyuria, polydipsia.

Renal threshold for glucose

Plasma glucose level (approximately 160–180 mg/dL) above which glucose appears in urine (glucosuria).

Ketonuria

Presence of ketones in urine, seen in diabetes mellitus with ketoacidosis and other fat-metabolism states.

Waxy and broad casts

Urine casts associated with end-stage renal disease; indicate severe renal damage.