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Erythropoeitin
Stimulates RBC production
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Lasix (furosemide)
- Loop diuretic, prevents body from absorbing too much salt, allowing salt to be passed in yoru urine.
- Treats fluid retention (edema) in people with liver disease/kidney disorder (nephrotic syndrome)
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Calcium
- 8.2-10.2
- Inverse relationship with phosphate
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Phosphorus
- 2.5-4.5
- Inverse relationship with calcium
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BUN
- 8-25
- Kidney function status
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Creatinine
- 0.8-1.4
- Kidney function status
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BUN/Creat ratios
- 20:1 prerenal
- 15:1 intrarenal/postrenal
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GFR
nomral
definition
influenced by...
- 125 mL/minute; 80% reabsorbed, 20% urine
- rate at which the filtrate (urine) is formed
- influenced by blood hydrostatic pressure & the filtrate osmotic pressure
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GFR: i/c BP= afferent arteriole ____
- i/c BP = afferent arteriole vasoconstriction
- MAP 90-250, GFR is proportional to perfusion pressure; if MAP falls greatly (shock) GFR will fall to near zero reulting in anuria
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GFR: d/c BP= afferent arteriole ____
- D/c BP= afferent arteriole dilation
- increasing perfusion of glomeruli
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3 phases of acute renal failure
- Prerenal
- Intrarenal
- Postrenal
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Prerenal failure
cause, BUN, tx
- Causes: renal vasoconstriction, hypotension, hypovolemia, hemorrhage, inadequate CO, massive vasodilation, obstruction of renal artery
- BUN: CR ratio 20:1
- Presenation: see notes
- Tx: goal is to restore perfusion & revent tubular damage
- volume depletion: crystalloids, colloids
- impaired cardiac function: positive inotropes
- Vasodilation: vasopressors & fluids
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Intrarenal failure
- Cause: glomerular injury, vascular injury, ATN
- BUN: Cr ratio 10:1 to 15:1
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Postrenal Failure
- Causes: obtruciton of urine flow from the kidney to the urethra (prostate problems)
- BUN: CR ratio 10:1 to 15:1
- Tx. aimed @ removing the blockage
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ATN phases
- 1. Onset
- 2. Oliguric/nonoliguric phase
- 3. Diuretic phase
- 4. Recovery
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ATN clinical presentation
voluem overload, metabolic acidosis, hyperkalemia, hypocalcemia/hyperphosphatemia, hematologic (anemia, d/c platelet function), uremia
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ADH
- changes permability of collecting tubes to water
- I/C levels: high permeability (highly concentrated urine in small amounts--dehydration)
- D/C: low permeability (larger volume of urine with elss concentration--large intake of water)
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RAA
Renin is stimulated when GFR falls due to dehydration or blood loss (can also be stimualted when sodium levels are low in the filtrate)
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Aldosterone
- stimulated by Angiotensin II
- Promotes reabsorption of Na and H2O to correct fluid defiicts, i/c BP, i/c Na & d/c K levels
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Hemodialysis
Principle of osmosis & diffusion to remove water products & excess fluid from the blood
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