Hydrostatic pressure of the blood
Pushing filtrate out of the capillary and into the glomerular capsule
HP Blood 55 - OP Blood 30 - HP Capillary = 10mm Hg
Osmotic pressure (Oncotic)
Pressure pulling water back into the capillary . It pulls by osmosis to try and balance the protein/water concentration in the blood vs. the filtrate.
HP Blood 55 - OP Blood 30 - HP Capillary = 10mm Hg
Hydrostatic pressure of the Capsule
The pressure exerted by the capsule to push filtrate back into the capillary. The capsule can only hold so much filtrate, so it creates a pressure pushing back like a balloon.
HP Blood 55 - OP Blood 30 - HP Capillary = 10mm Hg
Renal Threshold
The plasma concentration at which a substance begins to spill into the urine because its transport maximum has been surpressed is called the ________________.
TESTS OF KIDNEY FUNCTION
Proteinuria
Tests for the presence of excessive protein (chiefly albumin but also globulin) in the urine.
This usually indicates microscopic damage to the glomeruli.
TESTS OF KIDNEY FUNCTION
Blood Urea Nitrogen (BUN)
Test that determines the amount of urea, ammonia and nitrogen- containing compounds, waste products of amino groups in protein metabolism, in kidney failure, these compounds are found in blood samples.
TESTS OF KIDNEY FUNCTION
Creatinine
Test that determines the amount of creatinine, a waste product of muscle metabolism.
*Creatinine levels are directly related to muscle mass.
*Normal levels
Men 97-137 mL/min
Women 88-128mL/min
TESTS OF KIDNEY FUNCTION
Glomerular filtration rate
Test that measures how much blood is filtered through the glomerulus and becomes filtrate.
(Filtrate + Tubular processing ->Urine)
*NORMAL > 90mL / min
*Decreased in kidney disease
Urine
* CHEMICALS: water, urea, and small amounts of uric acid, creatinine, NA+, K+, bicarbonate.
* VOLUME: 1-2 liters/day
* COLOR: variable shades of yellow
* TURBIDITY: clear
* ODOR: variable
* PH: 5.0-6.5
* SPECIFIC GRAVITY: 1.005-1.025
Urinalysis
Biochemical (dipstick)
detects possible presence of blood, bilirubin, glucose, albumin, bacteria, and white blood cells.
UPPER URINARY TRACT OBSTRUCTION
-_______________
*stones
*blood vessel compression
*tumor
*scarring/fibrosis
-_______________
*stones
*tumor
#NAME?
LOWER URINARY TRACT OBSTRUCTION
-_________________
*neurogenic bladder
-_________________
*urethral stricture
*prostate enlargement (males)
*pelvic organ prolapse
*obstruction of urethra
#NAME?
Renal Calculi (kidney stones)
Caused by underlying disorders (infections, obstructions) increased dietary intake of specific chemicals (Ca++and PO4), high or low PH levels, and dehydration.
*Symptoms: Flank pain, radiating to the groin area, nausea, vomiting, and abdominal pain.
*Lab Findings: High urine specific gravity, hematuria
*Diagnoses: by performing an intravenous pyelogram (IVP).
*Treatment: High fluid intake, stone extraction, ston
Renal Calculi ( Kidney Stones) signs and symptoms
NEUROGENIC BLADDER
Obstructive Uropathy
Caused by an interruption of the nerve supply to the bladder. Both CNS or spinal cord damage can be a cause.
Loss of upper neuron=loss of voluntary control of elimination.
Loss of lower motor neurons= loss of voluntary and involuntary elimination.
Urinary Tract Infection
*An infection anywhere in the urinary tract
*E-COLI is the main pathogen for UTI's
*Caused by: surgery, catheters, diabetes, ptosis, prostatic hyperplasia, STD's
*Common in females, uncommon in males -- except for STDs which are equal in both sexes.
Symptoms:
- Dysuria (burning urination, urgency and frequency)
- Incontinence
- Low back or flank pain
Urinary Tract Infection symptoms
Cystitis
May be a infectious or non- infectious inflammation.
-obstruction, prostatitis, microorganisms.
*Signs and symptoms:
-painful, burning urination, frequency, urgency, hematuria (not Always), and foul smelling and cloudy urine.
*Lab findings: WBCs with/with
Pyelonephritis
May be a infectious or non- infectious inflammation. -obstruction, prostatitis, microorganisms.
-Ascending microorganisms, urinary obstruction, condition that causes urinary reflux, or urine retention.(organisms dont get flushed out)
*Signs and symptoms:
Glomerulonephritis
Group of diseases of the glomerulus that are caused by immune responses, toxins, vascular disorders, and other systemic diseases.
*Hallmark of these diseases is blood in the urine (hematuria).
*This inflammatory response changes the permeability of the gl
Common Types:
*Post streptococcal (PSGN)
*Rapidly progressing (crescentic)
*Membranoproliferative and minimal change disease (MCD)
*IgA nephropathy (Berger's Disease)
LABORATORY FINDINGS:
RBCs in urine
Proteinuria (3-5g/day)
RBC casts
Serum BUN and creati
Glomerulonephritis signs and symptoms
Nephrotic Syndrome
a syndrome characterized by edema and large amounts of protein in the urine and usually increased blood cholesterol.
Often a result of a different primary disease;
-Toxemia of pregnancy
-Diabetes
-Systemic lupus(SLE)
-Glomerulonephritis.
*Hyperlipidema results from the liver's response to the hypoalbuminemia.
Nephrotic Syndrome signs and symptoms
Pre-Renal (Renal Hypoperfusion)
Hypovolemia, Shock, Cardiac Failure, Hypotension
Intrarenal
This phase of Acute Renal Failure is caused by tissue damage of the glomerulus or tubules: Renal Ischemia, acute tubular necrosis, toxins, glomerulopathies, or malignancies. which causes loss of renal function. Find out what is causing it and do dialysis.
Post-renal (Urinary obstruction)
tumors, stones, clots and outlet obstructions. (Benign prostatic hyperplasia or urethral structures)
ACUTE RENAL FAILURE
A sudden decline in kidney function, accompanied by elevation of BUN and plasma creatinine.
PHASES:
Oliguria, begins day 1 and can go 1-3 weeks
Diuresis
Recovery
Acute Tubular Necrosis (ATN)
Most common cause of acute renal failure. associated with sepsis, burns, trauma, or severe episode of hypertension. Ischemia generates oxygen radicals and inflammatory mediators that causes swelling, injury, and necrosis of renal cells.
CHRONIC RENAL FAILURE
Results in a progressive and irreversible loss of nephron mass (renal atrophy). REsults in Uremia: the decline of renal function and the accumulation and retention of toxic wastes in blood.
Demonstrates:
Anemia, Metabolic acidosis, Elevated BUN levels, Hy
Diabetic Nephropathy
accumulation of damage to the glomerulus capillaries due to the chronic high blood sugars of diabetes mellitus
Treatment:
ACE inhibitors
Angiotensin II receptor antagonists
Diuretics
Beta Blockers
Alphblockers
Systemic effects of Uremia
Skeletal=_________________
Bone reabsorption
Systemic effects of Uremia Cardiopulmonary=__________________
Hypertension
Systemic effects of Uremia Neurologic=_____________________
Encephalopathy (uremic toxins)
Systemic effects of Uremia
Endocrine=____________________
Decreased growth hormone
Systemic effects ofUremia Hematologic=_____________________
Reduced erythropoietin
Systemic effects of Uremia
GI=_______________________
Retention of urochromes, urea, & acids
Systemic effects of Uremia
Immune=_______________________
Cell-mediated immunity suppression
Systemic effects of Uremia Reproduction=______________________
Sexual dysfunction, Amenorrhea, Infertility, Decreased libido