Acute Kidney Injury (AKI)
|
|
- Scott Lambert
- 5 years ago
- Views:
Transcription
1 (Last Updated: 08/22/2018) Created by: Socco, Samantha Acute Kidney Injury (AKI) Thambi, M. (2017). Acute Kidney Injury. Lecture presented at PHAR 503 Lecture in UIC College of Pharmacy, Chicago. AKI This is an acute decline in kidney function, whereas CKD must be renal dysfunction for >/= 3 months Non-preventable risk factor for AKI: o An AKI on top of CKD o Being older than 75 y/o o Having peripheral vascular disease o Heart failure o Liver disease o Diabetes Preventable risk factors for AKI o Nephrotoxins NSAIDs Aminoglycosides o Hypotension o Sepsis tx with antibiotics early enough, it s preventable Usually asymptomatic but can begin to show symptoms of CKD o Edema, increase in K +, Magnesium, Phosphate o Acidosis o High BUN TYPES OF AKI: PRE-RENAL Pre-renal = not enough blood getting to the kidney ischemia (kidney cells die) o Intravascular volume depletion Hypovolemia (dehydration) Hemorrhage GI loss (diarrhea/vomit) Frequent urination (thiazide + loop diuretic) Decreased effective volume = can t keep blood in vasculature (escaping into interstitium) cirrhosis, CHF
2 Peripheral vasodilation = shunting from kidney to periphery o Reduced cardiac output Hypotension HF (heart failure) MI (myocardial infarction) Certain drugs (calcium channel blockers) o Vascular obstruction Bilateral renal artery stenosis = closing off of the renal arteries Afferent arteriole vasoconstriction NSAIDs Epinephrine/norepinephrine Tacrolimus, cyclosporine (transplant drugs) o Diagnosis: History (did pt. get thiazide + loop diuretic?). is pt. dehydrated? Physical exam (orthostatic hypotension get dizzy when standing up) Dehydration = poor skin turgor Give fluids, if SCr gets better, then it s probably pre-renal, if not then it s probably intrinsic Labs BUN:SCr > 20 = dehydration Urine specific gravity > Urine osmolality > 500 Urine Na + <20 Na + low b/c body trying to keep Na + in to keep water Fractional excretion of Na + <1% (DIFFERENTIATES between pre-renal AKI and intrinsic AKI) o Excreted (filtered reabsorbed) / filtered o <1 % = pre-renal AKI o 1-2% = either pre-renal or intrinsic o > 2% = intrinsic AKI o Be careful: may not be accurate if pt. is urinating frequently (>500 ml/d) or on diuretics (use FEUrea instead) FEUrea < 35% = pre-renal AKI FEUrea 50-65% = intrinsic AKI o Progression of pre-renal AKI Get less blood flowing to kidney compensate by decreasing Na + output and activation RAAS (renin angiotensin aldosterone system) 2
3 get increase in aldosterone and ADH less urine output, less Na + excretion get highly concentrated urine with low Na + o Treating pre-renal AKI Hypovolemia = re-hydrate with ml bolus of 0.9% NaCl or Lactated Ringers (LR) and/or maintenance dose 35 ml/kg/day DON T use dextrose TYPES OF AKI: INTRINSIC Intrinsic = direct damage to the kidney itself (tubules, glomerulus, interstitial fluid) o Causes: Prolonged pre-renal AKI Prolonged post-renal AKI = urine backs up, nephrons are pressure sensitive Acute tubular necrosis (ATN) = sudden hypotension/ischemia Acute interstitial nephritis drug allergy or auto-immune induced (pt. may get rash and fever) Acute glomerulonephropathies (GNs)= usually drug-induced or autoimmune Pt usually has proteinuria = urine protein > 3.5 gm/d Get inflammation (proteins damage the tubules) nephritic syndrome Quantification done with 24 hr urine collection or spot albumin:creatinine ratio o Albumin:creatinine ratio is sensitive but not specific Nephrotic syndrome (different than Nephritic syndrome) = signs/symptoms seen in pt with proteinuria o Edema = losing albumin and cant keep volume in vasculature b/c of the decrease in oncotic pressure o Urine will look frothy o Ramped up protein production cholesterol production o Less antithrombin = higher risk for blood clots o Less complement protein and antibodies = higher risk infection Nephritic syndrome (different than nephrotic syndrome) = intraglomerular inflammation basically at end stage renal disease 3
4 o Will have all symptoms of nephrotic syndrome but also: Hematuria (RBCs are casted or dysmorphic) Oliguria Less CrCl Hypertension How to treat GNs: o Immunosuppressive therapy o Tx the proteinuria Increase dietary intake Use an ACEI (Angiotensinogen converting enzyme inhibitor) or ARB (angiotensin receptor blocker) w/ low salt diet o Tx hyperlipidemia (lifestyle mods) o Tx hypertension (ACEIs or ARBs) o Tx blood clots Anticoagulation only do this if they get a clot Acute = inpatient heparin Outpatient: warfarin or low molecular weight heparin o Tx edema Sodium restriction (<2 gm/day) Can try loop diuretics if really bad o When to start dialysis: AEIOU A = metabolic Acidosis (ph < 7.1) E = Electrolytes (K + > 6.5) I = Intoxication O = Refractory fluid Overload U = Uremia (person will be confused) Starting early will not improve outcomes however Types of dialysis (see dialysis study guide as well) Intermittent hemodialysis or peritoneal dialysis Continuous renal replacement therapy (CRRT) 4
5 TYPES OF AKI: POST-RENAL Post-renal = obstructing urine outflow to bladder or urethra o This causes urine to backup (hydronephrosis) more pressure on nephrons interstitial damage and risk of UTI (urinary tract infection) or pyelonephritis (infection of the kidneys) o Caused by: Congenital problems from childhood Calculi = kidney stones Benign prostatic hyperplasia (BPH) or prostate cancer usually in older men o Urolithiasis = stones that form in urinary system Nephrolithiasis = stones in kidney Ureterolithiasis = stones in ureters Pathophysiology: Build up of calcium/oxalate salts get crystal formation damages ureters crystals grow there recurrence from remnants Most made of calcium oxalate or calcium phosphate Some made of uric acid, struvite (magnesium ammonium phosphate diuretics increase risk of this), or cystine Risk factors: Diabetes, obesity, gout, HTN, previous kidney stone, hyperparathyroidism, family hx, bariatric surgery Low fluids, high salt diet, high protein diet, high sugar diet, drinking soda (phosphoric acid) Certain medications: ex.) loop diuretics Symptoms Asymptomatic Renal colic = spasm of the ureters Pain that waxes and wanes If stones > 10 mm, probably not going to pass on their own Medical expulsive therapy (MET) o Use tamsulosin (highest evidence), nifedipine, or tadalafil If stones < 5 mm can let pass on their own and hydrate the pt while controlling their pain Preventing stones: 5
6 Increase fluid intake and avoid dark sodas w/ phosphoric acid while keeping low sodium diet. Other ways have little evidence Using thiazide diuretics and potassium citrate DON T: take Vit. C, lower calcium in diet, or take calcium supplement 6
Dr.Nahid Osman Ahmed 1
1 ILOS By the end of the lecture you should be able to Identify : Functions of the kidney and nephrons Signs and symptoms of AKI Risk factors to AKI Treatment alternatives 2 Acute kidney injury (AKI),
More informationDisorders of the kidney. Urine analysis. Nephrotic and nephritic syndrome.
Disorders of the kidney. Urine analysis. Nephrotic and nephritic syndrome. Azotemia and Urinary Abnormalities Disturbances in urine volume oliguria, anuria, polyuria Abnormalities of urine sediment red
More informationAcute Kidney Injury. I. David Weiner, M.D. Division of Nephrology, Hypertension and Transplantation University of Florida and NF/SGVHS
Acute Kidney Injury I. David Weiner, M.D. Division of Nephrology, Hypertension and Transplantation University of Florida and NF/SGVHS 374-6102 David.Weiner@medicine.ufl.edu www.renallectures.com Concentration
More informationAlterations of Renal and Urinary Tract Function
Alterations of Renal and Urinary Tract Function Chapter 29 Urinary Tract Obstruction Urinary tract obstruction is an interference with the flow of urine at any site along the urinary tract The obstruction
More informationTherapeutics of Diuretics
(Last Updated: 08/22/2018) Created by: Socco, Samantha Therapeutics of Diuretics Thambi, M. (2017). The Clinical Use of Diuretics. Lecture presented at PHAR 503 Lecture in UIC College of Pharmacy, Chicago.
More informationCardiorenal and Renocardiac Syndrome
And Renocardiac Syndrome A Vicious Cycle Cardiorenal and Renocardiac Syndrome Type 1 (acute) Acute HF results in acute kidney injury Type 2 Chronic cardiac dysfunction (eg, chronic HF) causes progressive
More informationLow Efficacy Diuretics. Potassium sparing diuretics. Carbonic anhydrase inhibitors. Osmotic diuretics. Miscellaneous
University of Al Qadisiyah College of Pharmacy Dr. Bassim I Mohammad, MBChB, MSc, Ph.D Low Efficacy Diuretics 1. Potassium sparing diuretics 2. Carbonic anhydrase inhibitors 3. Osmotic diuretics 4. Miscellaneous
More informationStages of Chronic Kidney Disease (CKD)
Early Treatment is the Key Stages of Chronic Kidney Disease (CKD) Stage Description GFR (ml/min/1.73 m 2 ) >90 1 Kidney damage with normal or GFR 2 Mild decrease in GFR 60-89 3 Moderate decrease in GFR
More information1. Disorders of glomerular filtration
RENAL DISEASES 1. Disorders of glomerular filtration 2. Nephrotic syndrome 3. Disorders of tubular transport 4. Oliguria and polyuria 5. Nephrolithiasis 6. Disturbances of renal blood flow 7. Acute renal
More informationHYPERTENSION IN CKD. LEENA ONGAJYOOTH, M.D., Dr.med RENAL UNIT SIRIRAJ HOSPITAL
HYPERTENSION IN CKD LEENA ONGAJYOOTH, M.D., Dr.med RENAL UNIT SIRIRAJ HOSPITAL Stages in Progression of Chronic Kidney Disease and Therapeutic Strategies Complications Normal Increased risk Damage GFR
More informationElevated Serum Creatinine, a simplified approach
Elevated Serum Creatinine, a simplified approach Primary Care Update Creighton University School of Medicine. April 27 th, 2018 Disclosure Slide I have no disclosures and have no conflicts with this presentation.
More informationRENAL FUNCTION TESTS - Lecture
#Clinical Chemistry RENAL FUNCTION TESTS - Lecture Dr. Kakul Husain # The Kidney Kidneys are bean-shaped organs, each about the size of fist, located near the middle of the back, just below the ribs cage.
More informationACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS. Myriam Farah, MD, FRCPC
ACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS Myriam Farah, MD, FRCPC Clinical Assistant Professor Division of Nephrology, University of British Columbia November 2016 1. How to recognize acute
More informationCCRN Review - Renal. CCRN Review - Renal 10/16/2014. CCRN Review Renal. Sodium Critical Value < 120 meq/l > 160 meq/l
CCRN Review Renal Leanna R. Miller, RN, MN, CCRN-CMC, PCCN-CSC, CEN, CNRN, CMSRN, NP Education Specialist LRM Consulting Nashville, TN Sodium 136-145 Critical Value < 120 meq/l > 160 meq/l Sodium Etiology
More informationRenal Transporters- pathophysiology of drug - induced renal disorders. Lisa Harris, Pharmacist, John Hunter Hospital, Newcastle, 2015 November
Renal Transporters- pathophysiology of drug - induced renal disorders Lisa Harris, Pharmacist, John Hunter Hospital, Newcastle, 2015 November Renal Failure Up to 25% of acute renal failure is drug induced
More informationThe Renal System. David Carroll
The Renal System David Carroll dcarroll06@qub.ac.uk https://www.davidontheinter.net Learning Objectives What you need to pass your exam Anatomy Physiology Pharmacology Pathophysiology Renal Anatomy Renal
More informationHIHIM 409 7/26/2009. Kidney and Nephron. Fermamdo Vega, M.D. 1
Function of the Kidneys Nephrology Fernando Vega, M.D. Seattle Healing Arts Center Remove Wastes Regulate Blood Pressure Regulate Blood Volume Regulates Electrolytes Converts Vitamin D to active form Produces
More informationUrinary system disorders Chapter 29
Urinary system disorders Chapter 29 1 The Nephron Anatomy 2 Physiology 1.25 L per minute blood flow 25% of Cardiac Output Kidney compensates if one is lost - 2 weeks 3 Urine Formation 1. Filtration 2.
More informationUrolithiasis. Ali Kasraeian, MD, FACS Kasraeian Urology Advanced Laparoscopic, Robotic & Minimally Invasive Urologic Surgery
Urolithiasis Ali Kasraeian, MD, FACS Kasraeian Urology Advanced Laparoscopic, Robotic & Minimally Invasive Urologic Surgery Urolithiasis: Why should we care? Affects 5% of US men and women Men twice as
More informationNephrology - the study of the kidney. Urology - branch of medicine dealing with the male and female urinary systems and the male reproductive system
Urinary System Nephrology - the study of the kidney Urology - branch of medicine dealing with the male and female urinary systems and the male reproductive system Functions of the Urinary System 1. Regulation
More informationUrinary System. Analyze the Anatomy and Physiology of the urinary system
Urinary System Analyze the Anatomy and Physiology of the urinary system Kidney Bean-shaped Located between peritoneum and the back muscles (retroperitoneal) Renal pelvis funnelshaped structure at the beginning
More informationTHE KIDNEY AND SLE LUPUS NEPHRITIS
THE KIDNEY AND SLE LUPUS NEPHRITIS JACK WATERMAN DO FACOI 2013 NEPHROLOGY SIR RICHARD BRIGHT TERMINOLOGY RENAL INSUFFICIENCY CKD (CHRONIC KIDNEY DISEASE) ESRD (ENDSTAGE RENAL DISEASE) GLOMERULONEPHRITIS
More informationChapter 20 Diseases of the kidney:
Chapter 20 Diseases of the kidney: 1. Which of the following is seen in Nephrotic syndrome (2000, 2004) (a) Albumin is lost in the urine, while other globulins are unaffected (b) Early hypertension (c)
More informationCYSTIC DISEASES of THE KIDNEY. Dr. Nisreen Abu Shahin
CYSTIC DISEASES of THE KIDNEY Dr. Nisreen Abu Shahin 1 Types of cysts 1-Simple Cysts 2-Dialysis-associated acquired cysts 3-Autosomal Dominant (Adult) Polycystic Kidney Disease 4-Autosomal Recessive (Childhood)
More informationA&P 2 CANALE T H E U R I N A R Y S Y S T E M
A&P 2 CANALE T H E U R I N A R Y S Y S T E M URINARY SYSTEM CONTRIBUTION TO HOMEOSTASIS Regulates body water levels Excess water taken in is excreted Output varies from 2-1/2 liter/day to 1 liter/hour
More informationDefinition : Stages : ( RIFLE vs. AKIN ) Causes and classification : Pre-renal Renal Post- renal Clinical manifestations and Complication Management
AKI Definition : Stages : ( RIFLE vs. AKIN ) Causes and classification : Pre-renal Renal Post- renal Clinical manifestations and Complication Management and indications for RRT Etiology prerenal causes
More informationOutline Urinary System. Urinary System and Excretion. Urine. Urinary System. I. Function II. Organs of the urinary system
Outline Urinary System Urinary System and Excretion Bio105 Chapter 16 Renal will be on the Final only. I. Function II. Organs of the urinary system A. Kidneys 1. Function 2. Structure III. Disorders of
More informationRenal Regulation of Sodium and Volume. Dr. Dave Johnson Associate Professor Dept. Physiology UNECOM
Renal Regulation of Sodium and Volume Dr. Dave Johnson Associate Professor Dept. Physiology UNECOM Maintaining Volume Plasma water and sodium (Na + ) are regulated independently - you are already familiar
More informationNATIONAL KIDNEY MONTH
NATIONAL KIDNEY MONTH According to the WebMD website, kidneys have several specific roles: Maintain your body s balance of water and concentration of minerals, such as sodium, potassium, magnesium and
More informationProviding Home Infusion for the Patient with Compromised Renal Function
Providing Home Infusion for the Patient with Compromised Renal Function Carol J. Rollins, MS, PharmD, BCNSP Assistant Director, Clinical Pharmacy Services University Medical Center, Tucson, Arizona Top
More informationConflict of Interest. Providing Home Infusion for the Patient with Compromised Renal Function. Top 5 Things to Know for CE: 3/31/10
Providing Home Infusion for the Patient with Compromised Renal Function Carol J. Rollins, MS, PharmD, BCNSP Assistant Director, Clinical Pharmacy Services University Medical Center, Tucson, Arizona Top
More informationDrug Use in Dialysis
(Last Updated: 08/22/2018) Created by: Socco, Samantha Drug Use in Dialysis Drambarean, B. (2017). Drug Use in Dialysis. Lecture presented at PHAR 503 Lecture in UIC College of Pharmacy, Chicago. DIALYSIS
More informationRENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University
RENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University OBJECTIVES By the end of this lecture each student should be able to: Define acute & chronic kidney disease(ckd)
More informationAcute Renal Failure. Dr Kawa Ahmad
62 Acute Renal Failure Dr Kawa Ahmad Acute Renal Failure It is characterised by an abrupt reduction (usually within a 48- h period) in kidney function. This results in an accumulation of nitrogenous waste
More informationLearning Objectives. How big is the problem? ACUTE KIDNEY INJURY
ACUTE KIDNEY INJURY Karen Innocent, DNP, RN, CRNP, ANP-BC, CMSRN Executive Director, Continuing Education Wolters Kluwer Health, Inc May 2016 Orlando FL Learning Objectives Identify the risk factors and
More informationRenal pathophysiology.
Renal pathophysiology basa.konecna@gmail.com Outline Intro basic structure & physiology Nephrotic syndrome Nephritic syndrome Acute renal failure Chronic kidney disease Gross structure and location Kidney
More informationAcute Kidney Injury in the ED
+ Acute Kidney Injury in the ED + Dr Eric Clark, MD FRCPC University of Ottawa Canada Canadian Association of Emergency Physicians + Outline 1. Diagnostic challenges 2. ED treatment 3. Contrast induced
More informationIntroduction to Clinical Diagnosis Nephrology
Introduction to Clinical Diagnosis Nephrology I. David Weiner, M.D. C. Craig and Audrae Tisher Chair in Nephrology Professor of Medicine and Physiology and Functional Genomics University of Florida College
More informationThe Renal System. Dr Noel Sharkey
The Renal System Dr Noel Sharkey Learning Objectives Function Anatomy Physiology Pharmacology Pathophysiology The Function of the Kidney Excretion - Urea - Metabolites - Drugs Regulation - BP control (RAAS)
More informationDialyzing challenging patients: Patients with hepato-renal conditions
Dialyzing challenging patients: Patients with hepato-renal conditions Nidyanandh Vadivel MD Medical Director for Living kidney Donor and Pancreas Transplant Programs Swedish Organ Transplant, Seattle Acute
More informationnetwork of thin-walled capillaries closely surrounded by a pear-shaped epithelial membrane called the Bowman s capsule
Renal Terminology Renal-Root Words & Combining Forms calyx cortex glomerul/o medulla nephr/o pyel/o py/o ur/o ren/o cuplike division of the kidney outer layer of kidney glomerula inner or central portion
More informationA Practical Approach to Acute Kidney Injury
A Practical Approach to Acute Kidney Injury Elise Barney, DO Nephrologist Phoenix VA Medical Center Clinical Assistant Professor, Medicine University of Arizona College of Medicine A Tribute to the Kidney!
More informationPRINCIPLES OF DIURETIC ACTIONS:
DIURETIC: A drug that increases excretion of solutes Increased urine volume is secondary All clinically useful diuretics act by blocking Na + reabsorption Has the highest EC to IC ratio = always more sodium
More informationCKD FOR INTERNISTS. Dr Ahmed Hossain Associate professor Medicine Sir Salimullah Medical College
CKD FOR INTERNISTS Dr Ahmed Hossain Associate professor Medicine Sir Salimullah Medical College INTRODUCTION In 2002, the National Kidney Foundation s Kidney Disease Outcomes Quality Initiative(KDOQI)
More informationFunctions of the kidney:
Diseases of renal system : Normal anatomy of renal system : Each human adult kidney weighs about 150 gm, the ureter enters the kidney at the hilum, it dilates into a funnel-shaped cavity, the pelvis, from
More informationGeneral introduction of nephrology. Xiaoqiang Ding M.D., Ph.D. Department of nephrology Zhongshan Hospital, Fudan University
General introduction of nephrology Xiaoqiang Ding M.D., Ph.D. Department of nephrology Zhongshan Hospital, Fudan University Terminology Kidney,renal Nephrology Scope of nephrology Kidney diseases and
More informationClinical Significance of ARF. Hospital Acquired Renal Insufficiency. Case - Acute Renal Failure. Hospital Acquired Renal Insufficiency
Case - Acute Renal Failure 73 yo diabetic F w hx of mild HBP but normal renal function develops infection of R foot. Over 1 week fever, chills, inflammation swelling of her R foot and leg. She takes Motrin
More informationUrinary Disorders Objectives
Lemone and Burke Chapters 27, 28, 29, 48 Urinary Disorders Objectives Review anatomy and physiology Discuss etiology, pathophysiology, manifestation, management and nursing diagnosis of: Renal calculi
More informationKidneys and Homeostasis
16 The Urinary System The Urinary System OUTLINE: Eliminating Waste Components of the Urinary System Kidneys and Homeostasis Urination Urinary Tract Infections Eliminating Waste Excretion Elimination of
More informationOsmoregulation and Renal Function
1 Bio 236 Lab: Osmoregulation and Renal Function Fig. 1: Kidney Anatomy Fig. 2: Renal Nephron The kidneys are paired structures that lie within the posterior abdominal cavity close to the spine. Each kidney
More informationRenal and Urinary Tract Disorders
Renal and Urinary Tract Disorders Objectives: Congenital Kidney Disorders, Obstructive Kidney Disorders and Kidney cancer. Glomerular and Tubulointerstitial Disorders Acute Kidney Injury and Chronic Kidney
More informationChapter 23. Media Directory. Cardiovascular Disease (CVD) Hypertension: Classified into Three Categories
Chapter 23 Drugs for Hypertension Slide 37 Slide 41 Media Directory Nifedipine Animation Doxazosin Animation Upper Saddle River, New Jersey 07458 All rights reserved. Cardiovascular Disease (CVD) Includes
More information** Accordingly GFR can be estimated by using one urine sample and do creatinine testing.
This sheet includes the lecture and last year s exam. When a patient goes to a clinic, we order 2 tests: 1) kidney function test: in which we measure UREA and CREATININE levels, and electrolytes (Na+,
More informationNOTES: CH 44 Regulating the Internal Environment (Homeostasis & The Urinary System)
NOTES: CH 44 Regulating the Internal Environment (Homeostasis & The Urinary System) HOMEOSTASIS **Recall HOMEOSTASIS is the steady-state physiological condition of the body. It includes: 1) Thermoregulation:
More information만성콩팥병환자에서의혈압관리 분당서울대병원신장내과 안신영
만성콩팥병환자에서의혈압관리 분당서울대병원신장내과 안신영 Contents Introduction Lifestyle and Pharmacological Tx CKD ND ptswithout diabetes CKD ND ptswith diabetes In elderly ptswith CKD ND 2013 대한고혈압학회진료지침 JNC 8th Introduction
More informationNon-protein nitrogenous substances (NPN)
Non-protein nitrogenous substances (NPN) A simple, inexpensive screening test a routine urinalysis is often the first test conducted if kidney problems are suspected. A small, randomly collected urine
More informationChapter 23. Composition and Properties of Urine
Chapter 23 Composition and Properties of Urine Composition and Properties of Urine (1 of 2) urinalysis the examination of the physical and chemical properties of urine appearance - clear, almost colorless
More informationManagement of Hypertension. M Misra MD MRCP (UK) Division of Nephrology University of Missouri School of Medicine
Management of Hypertension M Misra MD MRCP (UK) Division of Nephrology University of Missouri School of Medicine Disturbing Trends in Hypertension HTN awareness, treatment and control rates are decreasing
More informationAcute Kidney Injury (AKI) Undergraduate nurse education
Acute Kidney Injury (AKI) Undergraduate nurse education Year One Developed Summer 2017 Overview Basic A & P of: Urinary system Kidneys Followed by: Introduction to Acute Kidney Injury Urinary System The
More informationAdvanced Concept of Nursing- II UNIT-VI Advance Nursing Management of Genitourinary (GU) Diseases.
In The Name of God (A PROJECT OF NEW LIFE COLLEGE OF NURSING KARACHI) Advanced Concept of Nursing- II UNIT-VI Advance Nursing Management of Genitourinary (GU) Diseases. Shahzad Bashir RN, BScN, DCHN,MScN
More informationMedicine Dr. Dana Lecture 1 Acute Kidney Injury (AKI)
Medicine Dr. Dana Lecture 1 Acute Kidney Injury (AKI) Renal function Kidney has many roles: 1. Excretory function 2. Osmolality regulation 3. Acid base balance 4. BP regulation through salt and water balance
More informationDiseases of the Renal System
Diseases of the Renal System Chapter 20 1 2 Kidneys - Anatomy Regulatory and metabolic functions Nephron - functional unit; approx. 1.2 million in each kidney Glomerulus within Bowman s capsule Afferent
More informationChapter 10: Urinary System & Excretion
Chapter 10: Urinary System & Excretion Organs of Urinary System Kidneys (2) form urine Ureters (2) Carry urine from kidneys to bladder Bladder Stores urine Urethra Carries urine from bladder to outside
More informationHMM 4401 Genito-urinary tract diseases
HMM 4401 Genito-urinary tract diseases Urine production Core elements: Glomerulus, proximal and distal convoluted tube, loop of Henle, collecting tubules, ureters, bladder, sphincter, uretra, and out
More informationDay 1 Bell Work We will be discussing one of FIVE excretory organs in the human body. We have already studied four of them. The kidneys are considered
URINARY SYSTEM 1 Day 1 Bell Work We will be discussing one of FIVE excretory organs in the human body. We have already studied four of them. The kidneys are considered the main organ in the excretory system.
More informationEXCRETION IN HUMANS 31 JULY 2013
EXCRETION IN HUMANS 31 JULY 2013 Lesson Description In this lesson we: Discuss organs of excretion Look at the structure of the urinary system Look at the structure and functioning of the kidney Discuss
More informationHTN, retenopathy, edema, encephalopathy
ARF Uremic syndrom Uremic syndrome (uremia) is a serious complication of CRF & ARF. It occurs when urea and other waste products build up in the body because the kidneys are unable to eliminate them. These
More informationSection 3, Lecture 2
59-291 Section 3, Lecture 2 Diuretics: -increase in Na + excretion (naturesis) Thiazide and Related diuretics -decreased PVR due to decreases muscle contraction -an economical and effective treatment -protect
More informationRISK FACTORS AND TREATMENT STRATEGIES FOR URINARY STONES Review of NASA s Evidence Reports on Human Health Risks
Mayo Clinic O Brien Urology Research Center RISK FACTORS AND TREATMENT STRATEGIES FOR URINARY STONES 2017 Review of NASA s Evidence Reports on Human Health Risks John C Lieske, MD July 27, 2017 What types
More informationDifficult to Treat Hypertension
Difficult to Treat Hypertension According to Goldilocks JNC 8 Blood Pressure Goals (2014) BP Goal 60 years old and greater*- systolic < 150 and diastolic < 90. (Grade A)** BP Goal 18-59 years old* diastolic
More informationThe Urinary S. (Chp. 10) & Excretion. What are the functions of the urinary system? Maintenance of water-salt and acidbase
10.1 Urinary system The Urinary S. (Chp. 10) & Excretion 10.1 Urinary system What are the functions of the urinary system? 1. Excretion of metabolic wastes (urea, uric acid & creatinine) 1. Maintenance
More information1. Urinary System, General
S T U D Y G U I D E 16 1. Urinary System, General a. Label the figure by placing the numbers of the structures in the spaces by the correct labels. 7 Aorta 6 Kidney 8 Ureter 2 Inferior vena cava 4 Renal
More informationIrish Practice Nurses Association Annual Conference Tullamore Court Hotel OCTOBER 6 th 2012
Irish Practice Nurses Association Annual Conference Tullamore Court Hotel OCTOBER 6 th 2012 Susan McKenna Renal Clinical Nurse Specialist Cavan General Hospital Renal patient population ACUTE RENAL FAILURE
More informationQuestions? Homework due in lab 6. PreLab #6 HW 15 & 16 (follow directions, 6 points!)
Questions? Homework due in lab 6 PreLab #6 HW 15 & 16 (follow directions, 6 points!) Part 3 Variations in Urine Formation Composition varies Fluid volume Solute concentration Variations in Urine Formation
More informationCardiac Pathophysiology
Cardiac Pathophysiology Evaluation Components Medical history Physical examination Routine laboratory tests Optional tests Medical History Duration and classification of hypertension. Patient history of
More informationHypertension Update. Sarah J. Payne, MS, PharmD, BCPS Assistant Professor, Department of Pharmacotherapy UNT System College of Pharmacy
Hypertension Update Sarah J. Payne, MS, PharmD, BCPS Assistant Professor, Department of Pharmacotherapy UNT System College of Pharmacy Introduction 1/3 of US adults have HTN More prevalent in non-hispanic
More informationIdentification and qualitative Analysis. of Renal Calculi
Identification and qualitative Analysis of Renal Calculi 1 -Renal Calculi: Kidney stones, renal calculi or renal lithiasis (stone formation) are small, hard deposits that form inside your kidneys. The
More informationKidney Fun and Failure
Kidney Fun and Failure Tom Ozbirn, M.D. General Session 2, Saturday, 9/8/12 9:30 a.m. to 11:30 a.m. Thomas W. Ozbirn, Jr DO, FACP Nephrology Associates, PC Birmingham, Alabama 1 Objectives Understand Categories
More informationThe Urinary System. BIOLOGY OF HUMANS Concepts, Applications, and Issues. Judith Goodenough Betty McGuire
BIOLOGY OF HUMANS Concepts, Applications, and Issues Fifth Edition Judith Goodenough Betty McGuire 16 The Urinary System Lecture Presentation Anne Gasc Hawaii Pacific University and University of Hawaii
More informationManagement of early chronic kidney disease
Management of early chronic kidney disease GREENLANE SUMMER GP SYMPOSIUM 2018 Jonathan Hsiao Renal and General Physician Introduction A growing public health problem in NZ and throughout the world. Unknown
More informationQuaseem et coll. Ann Intern Med 2014
Dietary and Pharmacologic Management to prevent Recurrent Nephrolithiasis in Adults A Clinical Practice Guideline From the American College of Physicians Introduction Approximately 80% of adults with kidney
More informationM2 TEACHING UNDERSTANDING PHARMACOLOGY
M2 TEACHING UNDERSTANDING PHARMACOLOGY USING CVS SYSTEM AS AN EXAMPLE NIGEL FONG 2 JAN 2014 TODAY S OBJECTIVE Pharmacology often seems like an endless list of mechanisms and side effects to memorize. To
More informationLow Urine Output. Hospitalist Team Intern Didactics M. Jackson, 2007
Low Urine Output Hospitalist Team Intern Didactics M. Jackson, 2007 Outline RN call- what to ask? Level of acuity- is this an emergency? Ddx Focused H & P- what to check signout for? ask? look for on exam?
More informationURINARY SYSTEM CHAPTER 28 I ANATOMY OF THE URINARY SYSTEM. Student Name
Student Name CHAPTER 28 URINARY SYSTEM L iving produces wastes. Wherever people live or work or play, wastes accumulate. To keep these areas healthy, there must be a method of disposing of these wastes
More informationRENAL & HEMATOLOGY EMERGENCIES JEFF SIMONS B.S. F-PC
RENAL & HEMATOLOGY EMERGENCIES JEFF SIMONS B.S. F-PC GOALS Overview of renal system anatomy / physiology Discuss common medical / trauma renal issues Identify associated assessment keys GOALS Introduction
More information2) This is a Point and Click question. You must click on the required structure.
Class: A&P2-1 Description: Test: Excretory Test Points: 144 Test Number: 28379 Printed: 31-March-10 12:03 1) This is a Point and Click question. You must click on the required structure. Click on the Bowman's
More informationMetabolic Stone Work-Up For Stone Prevention. Dr. Hazem Elmansy, MD, MSC, FRCSC Assistant Professor, NOSM, Urology Department
Metabolic Stone Work-Up For Stone Prevention Dr. Hazem Elmansy, MD, MSC, FRCSC Assistant Professor, NOSM, Urology Department Faculty/Presenter Disclosure Slide Faculty: Hazem Elmansy Relationships with
More informationChapter 16 Lecture Outline
Chapter 16 Lecture Outline See separate PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction
More informationThe Excretory System
The Excretory System The excretory system The excretory system includes the skin, lungs and kidneys which all release metabolic wastes from the body. The kidneys, skin and the lungs are the principle organs
More informationPediatric GU Dysfunction
Pediatric GU Dysfunction Assessment of pediatric renal function Signs and symptoms Laboratory tests Radiological tests Nursing considerations Psychosocial and developmental considerations GU Disorders
More informationBiomarkers of renal diseases. By Dr. Gouse Mohiddin Shaik
By Dr. Gouse Mohiddin Shaik Introduction Renal system performs several functions Excretory Waste products like urea, creatinine, drug, toxins clearance Regulatory Water, electrolyte and acid base balance
More informationCommon Concerns of the Kidney Harald Lausen, DO, FACOFP
Common Concerns of the Kidney Harald Lausen, DO, FACOFP Common Concerns of the Kidney Annual ACOFP Intensive Update and Board Review in Osteopathic Family Medicine Harald Lausen, DO, MA, FACOFP, FAODME,
More informationChapter 10 Worksheet Blood Pressure and Antithrombotic Agents
Complete the following. 1. A layer of cells lines each vessel in the vascular system. This layer is a passive barrier that keeps cells and proteins from going into tissues; it also contains substances
More informationSchool of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PLB SEMINAR
1 School of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PLB SEMINAR URINARY (RENAL) STONE FORMATION An Overview What are Urinary (Renal)
More informationA&P of the Urinary System
A&P of the Urinary System Week 44 1 Objectives Identify the organs of the urinary system, from a Identify the parts of the nephron (the functional unit List the characteristics of a normal urine specimen.
More informationRenal Disease. Please refer to the assignment page Three online modules TBLs
Renal Disease Please refer to the assignment page Three online modules TBLs 1 Renal Embryology 2 Lab Tests UA CBC Enzymes Creatinine Creatinine clearance Ammonia Abs C Bx 3 BUN Creatinine Creatinine Clearance
More informationManagement of common uroliths through diet
Vet Times The website for the veterinary profession https://www.vettimes.co.uk Management of common uroliths through diet Author : Marge Chandler Categories : Canine, Companion animal, Feline, Vets Date
More informationCKD IN THE CLINIC. Session Content. Recommendations for commonly used medications in CKD. CKD screening and referral
CKD IN THE CLINIC Family Physician Refresher Course Lisa M. Antes, MD April 19, 2017 No disclosures Session Content 1. 2. Recommendations for commonly used medications in CKD Basic principles /patient
More informationThe University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Nephrology
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Nephrology 1. GOAL: Understand the general pediatrician's role in diagnosis and management of hypertension in children.
More informationTherapeutic Agents for the Renal System
Therapeutic Agents for the Renal System Chapter 21 1 Anatomy and Physiology of the Renal and Urological Systems Kidneys: Located inside upper abdominal cavity on either side of vertebrae; bean shaped Renal
More information