Diseases/Conditions of the Renal System Flashcards
Diuretics
act to INCREASE urine volume output
typically also increase SOLUTE output
Edema
-presence of fluid in body tissues
2 types:
1) Intracellular
2) Extracellular
Intracellular Edema
Due to:
1) hyponatremia
2) metabolic depression
3) lack of adequate nutrition
Extracellular Edema
Due to:
1) fluid leakage
2) lymphatic failure
Causes:
- increased capillary pressure
- decreased plasma proteins
- increased capillary permeability
- decreased lymph return
Increased capillary permeability (ext. edema)
1) excessive kidney retention of salt and water
- kidney failure; mineralocorticoid excess
2) high venous pressure and venous constriction
- heart failure; venous obstruction; failure of venous pumps
3) decreased arteriolar resistance
- high body heat; decreased SNS; vasodilator drugs
Decreased plasma proteins (ext. edema)
- loss of proteins in the urine (NEPHROTIC SYMDROME)
- loss of proteins due to BURNS or WOUNDS
- decreased production of proteins (extreme dietary restriction; liver disease)
Increased capillary permeability (ext. edema)
- immune reactions - HISTAMINE
- toxins
- bacterial infection
- vitamin deficiency (vit C)
- prolonged ischemia
- burns
Decreased lymph return (ext. edema)
- cancer
- infections
- surgery
- congenital abnormality of lymphatic vessels
Edema - Natural Safety Factors
- interstitial fluid hydrostatic pressure in loose subcutaneous tissues of the body (suction)
- increase in lymph flow
- “washdown”
Washdown
- INC in interstitial fluid pressure = INC lymph flow
- DEC in interstitium protein concentration as we INC lymph flow
-DEC in protein -> DEC osmotic pressure -> fluid prevention from capillaries to interstitial fluid
T/F: Capillary pressure can rise double the normal amount before edema can occur.
TRUE
Hyponatremia
- plasma sodium is LOW
- Dehydration - loss of NaCl
- Overhydration - over retention of water (ADH)
- *MOST COMMON electrolyte disorder!!!
- can result in edema, brain swelling or damage, death
- rapid correction can also cause damage
Hypernatremia
- plasma sodium is HIGH
- Dehydration - water loss (lack ADH)
- Overhydration - excess NaCl (HIGH AHD)
-effects = less severe - cells resist damage from shrinkage
Nephrotic Syndrome
- caused by a variety of disorders that damage the kidneys at the glomerular membrane
- all result in RELEASE OF EXCESS PROTEIN in the urine
- children - minimal change disease; loss of PODOCYTE at glomerulus
- adults - membranous glomerulonephritis (disbetes, lupus, multiple myeloma)
Symptoms of Nephrotic Syndrome
1) Protein in urine (mostly ALBUMIN; foamy)
2) Edema
3) Others:
- dec appetite
- weight gain from fluid retention
- hypertension
- hyponatremia
- hylerlipidemia
Treatments/prevention of Nephrotic Syndrome
- decrease BP
- ACE inhibitors
- Corticosteroids
- Dietary changes
- Blood thinners
Nephritic Syndrome
Similar to nephrOtic syndrome; however, cells are now able to pass through the glomerular membrane
-acute membranous glomerulonephritis (abnormal immune response, severe infection)
Symptoms of Nephritic Syndrome
1) BLOOD in urine (RBC casts)
2) Protein in urine (albumin; foamy)
3) Hypertension
Cystitis
*Urinary tract infection - inflammation of bladder usually caused by bacterial infection
**if left untreated, can turn into PYELONEPHRITIS
Causes of cystitis
-Germs (bacteria) enter the urethra and bladder
Factors that increase frequency of cystitis
- urinary catheter
- blockage of bladder or uretha
- diabetes
- pregnancy
- narrow urethra
- immobility
Symptoms of cystisis
- persistent urge to urinate
- burning sensation when urinating
- pelvic discomfort
- lower abdominal pressure
- cloudy or bloody urine can have a strong odor
Pyelonephritis
*acute infection of the renal pelvis or parenchyma (usually due to an ascending infection - UTI)
Symptoms of pyelonephritis
Chills, fever, nausea, vomiting, unilateral or bilateral loin pain that can radiate to suprapubic region
Children and elderly can present no symptoms other than mental confusion
Nephrolithiasis
- KIDNEY STONES
- most common types=
1) CALCIUM OXALATE
2) CALCIUM PHOSPHATE
Symptoms of nephrolithiasis
- flank pain
- can come in waves
- uncomfortable
- nausea
- vomiting
- blood in urine
Causes of nephrolithiasis
1) imbalance of water (solutes in urine crystalize; too concentrated)
2) predisposition to having kidney stones runs in families
Treatment/prevention of nephrolithiasis
- increase fluid intake to help pass the stone
- pain medications
- surgery/scope
- sound waves
Polycystic kidney disease (PKD)
*a genetic disorder that causes the formation and enlargement of cysts in the kidneys
Symptoms of PKD
- blood in urine
- abdominal pain
- frequent kidney stones
- high blood pressure
- frequent UTI
- liver and pancreatic cysts
Causes of PKD
- *genetic disorder
1) Autosomal Dominant PKD (ADPKD) - Cysts develop in NEPHRONS (typically 30-40 yrs)
2) Autosomal Recessive PKD (ARPKD)
- seen in young children or the womb
- cysts develop in COLLECTING DUCTS
- can be very fatal
Treatment/prevention of PKD
- ease pain and prolong life
- medication to decrease BP and pain
- antibiotics to treat UTIs
- dialysis and kidney transplant after renal failure
Chronic Kidney Disease
- continual damage/loss of function in kidneys
- can be masked until 75% of ability to process is lost
- Steps:
1) injury
2) persistence
3) loss
4) adaptation
5) return to step 1
Initial kidney disease/damage
- loss of nephrons
- damage to remaining nephrons
- increased demand on remaining nephrons
- cardiovascular changes
Most common causes of CKD/end stage renal disease
1) diabetes mellitus 45% ***
2) hypertension 27%
3) glomerulonephritis 8%
4) PKD 2%
5) unknown 18%
Dialysis
- used both short and long term to treat loss of kidney function
- NOT as effective as actual kidneys
- functions via DIFFUSION only
- does NOT replace kidney functions (i.e., hormones)
- must sit attached to equipment for 4-6 hours (3X a week)
