Genitourinary System + Kidney Disease Flashcards
What is the genitourinary system and what is its function?
The organs of the reproductive system and the urinary system:
Kidneys
Ureter
Urinary Bladder
Urethra
Penis
Vagina
Testes
Ovaries
Uterus
The major functions of the genitourinary system are reproduction and also the removal of waste as part of its urinary system role.
The urinary system also helps regulate blood volume and blood pressure and control levels of electrolytes and metabolites and regulate blood pH.
Name and describe some urinary system disorders
Nephropathy - Damage or disease of a kidney
Nephritis - Inflammatory kidney disease
Chronic kidney disease - Kidney disorder ongoing for > 3 weeks
Urinary tract infection - Infection of the urinary tract (lower - cystitis, upper - pyelonephritis
Calculi - Kidney stones; urinary tract stones
Incontinence - loss of bladder control
Prostatitis - inflammation of the prostate
Define Chronic Kidney Disease (CKD)
CKD is a long term condition where the kidneys no longer function to filter blood as well as they should.
Can be defined as a pathological abnormality of the kidney such as haematuria and or proteinuria or a reduction in GFR to <60 mL/min for > 3 months duration
Other names for the same condition include:
Chronic Renal Failure, Chronic Renal Disease, Chronic Renal Insufficiency
What are the symptoms of late stage CKD?
Weight loss and poor appetite
Oedema of ankles
Dyspnea - Shortness of breath
Fatigue
Haematuria - Blood in urine
Polyuria and nocturia - Excessive production of urine, causing patient to urinate frequently and in the middle of the night
Insomnia
What can contribute to the development of CKD?
Hypertension - over time causes damage to the blood vessels of the kidneys
Diabetes - prolonged hyperglycaemia can cause damage to the filters of the kidneys
Kidney infections
Glomerulonephritis - inflammation of the kidneys
Congenital kidney defects
Renal artery stenosis - narrowing of renal artery
Polycystic kidney disease
Kidney stones
Acute kidney injury
Long term use of lithium or NSAIDs
What are some differential diagnoses for CKD?
Acute kidney injury
Alport syndrome
Chronic glomerulonephritis
Diabetic nephropathy
Multiple Myeloma
Systemic lupus erythematosus (SLE)
Renal artery stenosis
Urinary tract obstruction
What does GFR stand for
Glomerular Filtration Rate
A measure of kidney function, specifically it estimates how much blood passes through the glomeruli (filters of the kidneys) each minute
Normal or high - >90 mg/mmol
Mildly decreased - 60-90 mg/mmol
Moderately decreased - 30-59 mg/mmol
Severely decreased - 15-29 mg/mmol
Kidney failure - <15 mg/mmol
How is CKD classified?
Stage 1 - Mild kidney damage = eGFR >90 ml per min
Stage 2 - Mild kidney damage = eGFR 60-89
Stage 3 - Moderate kidney damage = eGFR 30-59
Stage 4 - Severe kidney damage = eGFR 15-29
Stage 5 - Kidney failure = eGFR <15
How is CKD treated?
Varies depending on the stage:
Stages 1-2 - ACE inhibitors (e.g ramipril, lisinopril) or angiotensin II agonists (ARBs), statin, other anti-hypertensive
Non-dihydropyridine calcium channel blocker, statin, other anti-hypertensive
These medicines are used for renal protection as they reduce hypertension
Stages 3-4
Above medications, possible addition of ezetimibe (anti-cholesterol)
Education about possible renal replacement therapies (dialysis and transplantation)
Management of additional complications such as anemia, metabolic acidosis, hyperkalemia, bone density disorders, hyperparathyroidism
Stage 5
Dialysis or transplantation
What is the prognosis for patients with CKD?
It will progress and eventually lead to end stage renal disease (ESRD)
CKD is a strong contributor to the development of cardiovascular disease and as such many patients die before reaching ESRD
What is a urinary tract infection?
Urinary Tract Infection (commonly abbreviated as UTI) is an infection of any part of the urinary system including the kidneys, ureters, bladder and urethra.
Most infections involve lower urinary tract, ie bladder and urethra
Highest incidence is among young women
Name the common symptoms of UTIs
A strong persistent urge to urinate
A burning sensation when urinating
Passing frequent, small amounts of urine
Urine that appears cloudy
Blood in urine
Strong-smelling urine
Pelvic pain in women
What are the 4 sub-classifications of UTIs?
Pyelonephritis - Infection of the kidneys
Uretertitis - Infection of the ureter
Cystitis - Infection of the bladder
Urethritis - Infection of the urethra
What are the signs and symptoms of pyelonephritis?
Upper back and flank pain
High fever
Shaking and chills
Nausea
Vomiting
What are the signs and symptoms of cystitis?
Pelvic pressure
Lower abdominal discomfort
Frequent, painful urination
Blood in urine
