Kidney conditions

Acute Kidney Injury (AKI)

• Rapid and sudden loss of kidney function.

• Reversible.

• Causes:

  • Prerenal: Hypovolemia, decreased CO, lowered BP, decreased renovascular blood flow.

  • Intrarenal: Trauma, renal artery or vein stenosis, acute nephrotoxins, infection, vasculitis, acute glomerulonephritis.

  • Postrenal: Obstruction of urine flow, hydronephrosis, bilateral obstruction.

• Signs & Symptoms:

  • ↓ Urine output

  • Fluid retention (edema)

  • High BUN & creatinine

  • Confusion, fatigue, nausea

• Diagnostics:

  • Labs: ↑ BUN, ↑ creatinine, ↓ GFR

  • Urinalysis

  • Imaging: ultrasound, CT

• Treatments:

  • Treat cause (fluids for dehydration, stop nephrotoxic drugs)

  • Dialysis if severe

  • Monitor I&O, daily weights, labs

• Complications:

  • Electrolyte imbalances

  • Metabolic acidosis

  • Fluid overload

  • Chronic kidney disease (if unresolved)

• Nephrotoxic Drugs:

  • NSAIDs

  • Aminoglycosides (e.g., gentamicin)

  • IV contrast dye

  • Vancomycin

  • Chemo drugs (cisplatin)

Chronic Kidney Disease (CKD)

• Gradual loss of kidney function over months/years.

• Causes:

  • Diabetes (#1)

  • Hypertension (#2)

  • Glomerulonephritis

  • Polycystic kidney disease

• Signs & Symptoms:

  • Fatigue, weakness

  • Edema

  • Itching (uremic frost)

  • Anemia

  • N/V

  • Confusion

  • ↓ urine output

• Body Systems Affected:

  • ❤ CV: HTN, heart failure

  • 🧠 Neuro: confusion, seizures

  • 🩸 Hematologic: anemia

  • 🦴 Bones: calcium/phosphate imbalance

  • 🌬 Resp: fluid in lungs

• Diagnostics:

  • Labs: ↑ BUN/Creatinine, ↓ GFR

  • Urinalysis: protein in urine

  • Imaging

  • Kidney biopsy (sometimes)

• Treatments:

  • Slow progression: control BP & blood sugar

  • Dialysis

  • Kidney transplant

• Dietary Needs:

  • ↓ Protein

  • ↓ Sodium, potassium, phosphorus

  • Fluid restriction

• Complications:

  • Anemia

  • Bone disease

  • Electrolyte imbalance

  • Heart problems

  • Uremia

Polycystic Kidney Disease (PKD)

• Inherited condition causing cysts in kidneys

• Causes:

  • Genetic (autosomal dominant or recessive)

• Signs & Symptoms:

  • High BP

  • Flank pain

  • Enlarged kidneys

  • Blood in urine

  • UTIs

  • Kidney stones

• Diagnostics:

  • Ultrasound

  • CT/MRI

  • Genetic testing

• Treatments:

  • Manage BP (ACE inhibitors)

  • Pain control

  • Prevent infections

  • Dialysis or transplant if kidney failure

• Complications:

  • Kidney failure

  • Liver cysts

  • Brain aneurysms

  • Heart valve issues

Renal Calculi (Kidney Stones)

• Hard stones formed in kidneys (calcium, uric acid, etc.)

• Causes:

  • Dehydration

  • High calcium or uric acid in urine

  • Diet (high oxalates or protein)

  • Family history

• Signs & Symptoms:

  • Severe flank/back pain

  • Nausea/vomiting

  • Hematuria (blood in urine)

  • Painful urination

  • Fever/chills (if infection)

• Diagnostics:

  • CT scan (best test)

  • Ultrasound

  • Urinalysis

  • Stone analysis

• Nursing Care & Treatments:

  • Pain meds (NSAIDs or opioids)

  • Hydration

  • Strain urine for stone

  • Lithotripsy (break stones)

  • Surgery if too big

  • Prevent future stones: diet changes, meds

• Complications:

  • Infection

  • Obstruction

  • Kidney damage