Acid-Base & Renal
Normal blood pH must stay within this narrow range.
What is 7.35 to 7.45?
In respiratory acidosis, pH moves this way and PaCO₂ moves this way.
pH decreases, PaCO₂ increases.
In metabolic acidosis, pH and bicarbonate (HCO₃⁻) move in these directions.
Both pH and HCO₃⁻ decrease.
This condition is a sudden decline in kidney function that leads to the accumulation of waste products and disturbances in fluid and electrolytes.
What is acute kidney injury (AKI)?
This long-term condition involves progressive, irreversible loss of kidney function.
What is chronic kidney disease (CKD)?
This ABG value tells you how well the lungs are excreting carbonic acid.
What is PaCO₂?
In respiratory alkalosis, pH and PaCO₂ change in these directions.
pH increases, PaCO₂ decreases.
In metabolic alkalosis, pH and bicarbonate change in these directions.
Both pH and HCO₃⁻ increase
In AKI, decreased blood flow to the kidneys is called this type, direct damage to kidney tissue is this type, and obstruction to urine flow is this type.
What are prerenal, intrarenal, and postrenal causes?
As CKD progresses, these nitrogenous waste products accumulate, leading to uremic symptoms.
What are urea and creatinine (and other nitrogenous wastes)?
This ABG value reflects how well the kidneys are excreting metabolic acid.
What is HCO₃⁻ (bicarbonate)?
Hypoventilation from COPD, oversedation, or respiratory muscle weakness can lead to this acid–base disorder.
What is respiratory acidosis?
Diabetic ketoacidosis, renal failure, and severe diarrhea are common causes of this acid–base disorder.
What is metabolic acidosis?
Dehydration and hypotension are classic examples of this category of AKI cause.
What are the prerenal causes?
Hyperkalemia and metabolic acidosis are examples of this broad type of problem found in CKD.
What are electrolyte and acid–base imbalances?
The three key processes that maintain acid–base balance are acid production, acid buffering, and this.
What is acid excretion?
Anxiety, pain, or fear causing hyperventilation most commonly produce this acid–base imbalance.
What is respiratory alkalosis?
Prolonged vomiting, gastric suction, or excessive antacid use can lead to this acid–base disorder.
What is metabolic alkalosis?
During the maintenance (oliguric) phase of AKI, urine output and fluid status typically look like this.
Urine output decreases (oliguria), and the patient shows signs of fluid volume excess (edema, hypertension).
Hemodialysis removes solutes and fluid from the blood using these three basic principles.
What are diffusion, osmosis, and ultrafiltration?
Name two of the four major risk factor patterns that can lead to acid–base imbalance.
Excess metabolic acid production or intake, altered acid buffering (loss/gain of bicarbonate), altered acid excretion, or abnormal shift of H⁺ into cells.
ABG: pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 24 mmol/L. Identify the imbalance.
Uncompensated respiratory acidosis.
With metabolic acidosis, the lungs compensate in this way; with metabolic alkalosis, they compensate in this opposite way.
Metabolic acidosis: hyperventilation to blow off CO₂ (↓PaCO₂); metabolic alkalosis: hypoventilation to retain CO₂ (↑PaCO₂).
Older adults are more susceptible to AKI partly because of this age-related change in kidney structure and common comorbidities.
They have fewer functioning nephrons and often have other conditions like cardiovascular disease or dehydration that increase AKI risk.
Hypotension, muscle cramps, blood loss, and disequilibrium syndrome are potential complications of this CKD treatment.
What is hemodialysis?