Page 647 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

Renal ` RENAL—PAthoLogy Renal ` RENAL—PAthoLogy SeCTIOn III 603

Consequences of renal Decline in renal filtration can lead to excess 2 forms of renal failure: acute (eg, ATN) and
failure retained nitrogenous waste products and chronic (eg, hypertension, diabetes mellitus,
electrolyte disturbances. congenital anomalies).
Consequences (MAD HUNGER): Incremental reductions in GFR define the stages
ƒ Metabolic Acidosis of chronic kidney disease.
ƒ Dyslipidemia (especially  triglycerides)
ƒ High potassium
ƒ Uremia—clinical syndrome marked by:
ƒ Nausea and anorexia
ƒ Pericarditis
ƒ Asterixis
ƒ Encephalopathy
ƒ Platelet dysfunction
ƒ Na /H O retention (HF, pulmonary edema,
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hypertension)
ƒ Growth retardation and developmental delay
ƒ Erythropoietin deficiency (anemia)
ƒ Renal osteodystrophy

Renal osteodystrophy Hypocalcemia, hyperphosphatemia, and failure of vitamin D hydroxylation associated with chronic
kidney disease Ž 2° hyperparathyroidism Ž 3° hyperparathyroidism (if 2° poorly managed).
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High serum phosphate can bind with Ca Ž tissue deposits Ž  serum Ca .  1,25-(OH) D
2 3
Ž  intestinal Ca absorption. Causes subperiosteal thinning of bones.
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FAS1_2019_14-Renal.indd 603 11/7/19 5:42 PM