ACUTE and CHRONIC
RENAL FAILURE
RENAL ASSESSMENT
Structure and Functions of
the Renal System
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Structure and Functions of the
Renal System: Nephron
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Purpose of the Kidneys
• Kidneys perform certain functions
– EXCRETORY
– REGULATORY
– ENDOCRINE
The purpose is so that the body can
maintain homeostasis
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Purpose of the Kidneys
• RID THE BODY OF WASTES OF METABOLISM
(UREA, CREATININE)
• MAINTAIN FLUID AND ELECTROLYTE BALANCE:
• ACTIVATE VITAMIN D
• MAINTAIN ACID-BASE BALANCE
• CONTROL BLOOD PRESSURE
• STIMULATE RBC PRODUCTION & PROLONG RBC
LIFE
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ASSESSMENT OF RENAL
FUNCTION
• Blood tests
• Urinalysis
• Clearance tests
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ASSESSMENT OF RENAL
FUNCTION
• Blood tests:
– plasma creatinine (more reliable than
BUN as a determinant of renal function)
• Normal: 44 – 133 μmol/Litre
– blood urea nitrogen, BUN levels
• Normal: 1.8 – 7.1 mmol/Litre
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ASSESSMENT OF RENAL
FUNCTION
• Urinalysis
– total urine volume and specific gravity:
• 1.016 – 1.022
– proteinuria (albuminuria)
– WBCs, RBCs, casts
– bacteria in the urine
– Creatinine: 124 -230 μmol/kg/day
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ASSESSMENT OF RENAL
FUNCTION
• Clearance tests
– 24 hour Creatinine Clearance tests:
estimate of GFR
• 1.5 – 2.3 mL/sec
– How done?
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Assessment of
the Urinary System
• Subjective Data
– Important Health Information
• Past health history
• Medications
• Surgery or other treatments
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Assessment of
the Urinary System (cont.)
– Functional Health Patterns
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Health perception – health management
Nutritional – metabolic
Elimination
Activity – exercise
Sleep – rest
Cognitive – perceptual
Self-perception – self-concept
Role – relationship
Sexuality – reproductive
Coping – stress tolerance
Value – belief
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Assessment of
the Urinary System (cont.)
• Objective Data
– Physical Examination
• Inspection
• Palpation
• Percussion
• Auscultation
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