- Lab findings
- BUN – indicator of glomerular filtration rate and is affected by the breakdown of
protein.
- Serum creatinine – waste product of skeletal muscle breakdown and is a better
indicator of kidney function.
- Creatinine clearance is best determent of kidney function (GFR). Must be a 24 hour
urine collection.
- K+
- The kidneys are means which K+ is excreted. Normal is 3.5-5.0 ,mEq/L. maintains
muscle contraction and is essential for cardiac function.
- Both elevated and decreased can cause problems with cardiac rhythm
- Hyperkalemia is treated with IV glucose and Na Bicarb which pushes K+ back into
the cell - Kayexalate ( Sodium polystyrene sulfonate ) is also used to promote the exchange of
sodium and potassium in the body.
- Ca
++ - With disease in the kidney, the enzyme for utilization of Vit D is absent
- Ca absorption depends upon Vit D
- Also, phosphate level increase leading to decreasing level of Ca
- Parathyroid hormone level increase in attempt to increase calcium, but because of the
high phosphorus level, there is limited response.
- Body moves Ca out of the bone to compensate.
- Renal osteodystrophy is the end result
Hypocalcemia = tetany
Parathyroid hormone level increase in attempt to increase calcium, but because of the
high phosphorus level, there is limited response.
- Other abnormal findings
- Metabolic acidosis
- Fluid imbalance
- Insulin resistance