Chapt 22 Patho

Cardiac Output to Kidneys

The kidneys receive 20% to 25% of the body’s cardiac output.

Urine Measurement in ICU

Measuring urine output every hour helps identify notable reduced urine production, indicating serious kidney injury.

Insulin and Renal Failure

Renal failure affects insulin administration, requiring higher levels of insulin due to decreased degradation.

Elevated BUN Causes

Dehydration is a likely cause of elevated blood urea nitrogen (BUN) in a client.

Kidney Stones and Genetics

A genetic predisposition is the most likely reason for the formation of renal calculi in the client.

Chronic Renal Failure

A diagnosis of systemic lupus erythematosus indicates chronic renal failure.

Protein Deficiency and Kidney Stones

A deficiency of the protein nephrocalcin inhibits stone formation, relating to renal calculi.

Goodpasture’s Syndrome Manifestations

60% to 80% of clients diagnosed with Goodpasture’s syndrome have clinically apparent pulmonary and renal disease.

High-Risk Indicators for Goodpasture’s

Anti–glomerular basement membrane (GBM) antibodies indicate a high risk for developing Goodpasture’s syndrome in the kidney and lungs.

Chemotherapy and Renal Calculi

Urine supersaturated with cystine is an associated characteristic of renal calculi in clients undergoing chemotherapy.

Urinalysis Indicating Illness

A serum creatinine level of 10 mg/dL indicates a state of illness in the client.

Kidney Secretory Functions

Clients with impaired renal function have disrupted calcium balance in the bloodstream due to inactive vitamin D.

Pathology of Renal Disorders

Postrenal dysfunction can be accompanied by an increased risk of infection.

Urinalysis and Renal Dysfunction

Urine containing crystals indicates the client is experiencing renal dysfunction.

Indicators of Renal Impairment

High amount of leukocyte esterase and decreased creatinine clearance indicate renal impairment.

Peritoneal Dialysis vs

PD is a slower process used for clients who are hemodynamically unstable.

Decreased GFR Reasons

A decrease in the client’s blood pressure and renal perfusion can lead to decreased glomerular filtration rate (GFR).

Proteinuria Indicators

Foamy urine and protein excretion in urine of 200 mg/day indicate the client is experiencing proteinuria.

Nephrolithiasis Treatment Review

“A low-sodium diet is recommended to limit fluid overload” indicates the need for additional review.

Causes of Nephrolithiasis

Excess uric acid excretion and family history of renal calculi are possible causes of nephrolithiasis.

Effects of RAAS

Sodium reabsorption and water reabsorption are net effects of the renin–angiotensin–aldosterone system (RAAS).

Risks from Edema and Distention

Compression of kidney tissue and ischemia are risks if edema and distention continue.

Kidney Stone Formation Steps

3, 5, 2, 4, 1 (Calcium phosphate deposits, Randall plaque forms, collects layers of collagen, becomes calculus, erodes through urothelium).

Edema in Acute Glomerulonephritis

6, 3, 4, 2, 5, 1 (Antigen enters, complexes damage glomeruli, hyperpermeability occurs, loss of albumin, diminished COP, hydrostatic pressure overcomes).

Changes in Polycystic Kidney Disease

2, 4, 3, 1, 5 (Outpocketing of nephron walls, hyperplasia of renal cells, cysts develop blood vessels, blood leaks into cysts, cystic walls stretch).