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Clinical Nutrition I Renal Diseases Exam Questions and Answers
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Clinical Nutrition I Renal Diseases Exam Questions and Answers
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Clinical Nutrition I: Renal Diseases ExamQuestions and Answers
Physiological iifunctions iiof iithe iikidneys
The iikidneys iiare iimade iiup iiof iia iicomplex iicapillary iinetwork iiand iitubules
They iifilter ii1600 iiL iiblood iieach iiday, iifrom iiwhich ii200 iiL iiultrafiltrate iiis iiproduced
99% iiof iithe iiultrafiltrate iiis iireabsorbed, iithe iiremaining ii1.5 iiL iiis iiexcreted iias
iiurine
What iiis iichronic iikidney iidisease ii(CKD)?
CKD iiis iia iisyndrome iiof iiprogressive iiand iiirreversible iiloss iiof iithe iifunctions iiof
iikidney iisecondary iito iikidney iidamage
Incidence iiand iiprevalence iiof iiCKD iiis iiincreasing iiin iithe iiUS
Epidemiology iiof iiCKD
,Risk iifactors iifor iiCKD
African iiAmericans iiare iinearly ii4x iias iilikely iito iidevelop iikidney iifailure iias iiwhite
iiAmericans
CKD iiruns iiin iifamilies
Prolonged iiconsumption iiof iiOTC iipainkillers iithat iicombine iiaspirin,
iiacetaminophen, iiand iiibuprofen
Diabetic iiNephropathy
Diabetic iinephropathy iiis iithe iileading iicause iiof iiend-stage iirenal iidisease ii(ESRD)
Diabetic iinephropathy iiis iidamage iito iiyour iikidneys iicaused iiby iidiabetes.
Affects ii20-30% iiof iiindividuals iiwith iidiabetes iimellitus
# iirisk iiis iigreater iiif iiblood iisugars iiare iinot iicontrolled
Advanced iiglycation iiend iiproducts ii(AGEs), iioxidative iistress, iiand iihypertension
iisynergistically iilead iito iirenal iidamage.
,Diabetic iiNephropathy
more iidetails
Earliest iidetectable iichange iiis iithe iithickening iiof iithe iiglomerulus
# iiperhaps iicaused iiby iihyperglycemia
Since iithe iiglomerulus iiis iiresponsible iifor iifiltering iithe iiblood iiand iithe iifluid iithat
iieventually iiforms iiurine...
# iithese iiglomerular iichanges iimay iiallow iimore iialbumin ii(a iiprotein) iithan iinormal
iito iibe iiexcreted iiin iiurine
# iiproteins iiin iirenal iitubule iitrigger iiinflammatory iiand iiimmune iievents iileading iito
iiprogressive iitubule iiinjury
As iidiabetic iinephropathy iiprogresses
# iiglomeruli iiare iidestroyed
# iimore iialbumin iiis iisecreted
# iinephron iifunction iideclines; iithose iithat iiremain iifunctioning iimust iiclear iian
iiincreasing iisolute iiload
Eventually, iithe iilimit iito iithe iiamount iiof iisolute iithat iican iibe iicleared iiis iireached
# iithe iiconcentration iiin iibody iifluids iiincreases
# iileads iito iiazotemia ii(high iilevels iiof iinitrogenous iiwaste iiproducts iiin iiblood)
# iiand iito iiuremia ii(high iilevels iiof iiwaste iiproducts iiin iiblood)
Urine iiformation
Urine iiformation iiis iia iicrucial iicomponent iiin iithe iimaintenance iiof iihomeostasis
Systemic iiblood iipasses iithrough iithe iiglomerulus
# iifilters iilarge iiproteins iiand iiblood iicells
# iiwhat's iileftover iiis iicalled iiULTRAFILTRATE ii(similar iito iithe iicomposition iiof
iiblood)
, Ultrafiltrate iithen iimoves iithrough iithe iitubules
# iimost iiof iiits iicomponents iiare iireabsorbed, iiincluding:
glucose, iiAAs, iiminerals iiand iiwater
# iialdosterone iicauses iisodium iito iibe iireabsorbed iiin iithe iiproximal iitubule
Vasopressin iicontrols iithe iifinal iiphase iiof iiurine iiproduction
# iiit iidirects iiconcentration iiof iiurine
# iiassists iiin iimaintaining iioverall iifluid iibalance
# iiurine iiosmolarity iiand iivolume iican iivary iiwidely
Identify iithe iinutrients iithat iiare iipresent iiin iithe iiultrafiltrate iiand iithe iiones iithat
iiare iireabsorbed iior iiexcreted
NUTRIENTS iiPRESENT iiIN iiULTRAFILTRATE
# iiglucose
# iivitamins
# iielectrolytes
# iinitrogenous iiwaste.
# iiprotein ii(albumin) ii+ iiblood iicells iishould iiNOT iibe iipresent iiin iiultrafiltrate
REABSORBED ii(by iitubules iiinto iirenal iicapillaries)
glucose, iiAAs, iielectrolytes ii(sodium), iiminerals, iiand iiwater
EXCRETED
# iinitrogenous iiwastes iiand iiother iimetabolic iiwastes
ex) iiurea, iiammonia, iicreatinine
More iion...
Aldosterone ii// iiVasopressin
Sodium iiis iiregulated iiby iithe iikidneys iiunder iithe iicontrol iiof iiALDOSTERONE
If iiserum iisodium iilevels iiare iielevated, iisodium iiis iiexchanged iiwith iipotassium
# iithis iirestores iihomeostasis
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