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
• 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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