HLTH 2501: kidney review Flashcards
where are the majority of the glomeruli located?
in the cortex of the kidneys
what form the filtration unit for blood?
the renal capsule that is the Bowman’s capsule and the glomerulus
what happens when the filtration pressure increases?
more filtrate forms and more urine is produced
transport maximum
is a limit of reabsorption of certain molecules, ex. glucose can only be absorbed so much so it is common for glucosuria to be present
glucosuria
presence of glucose in the urine
ADH
released from the posterior pituitary to alter the reabsorption of water in the DCT and CT
aldosterone
is secreted by the adrenal cortex and controls sodium reabsorption and water in the DCT
ANH
is released from the heart and reduces sodium and fluid reabsorption in the kidneys
what does each renal artery pass through?
the renal pelvis
why is any obstruction of blood flow in the kidneys dangerous?
because there are no anastomoses present between the interlobar and arcuate arteries, therefore no alternative blood supply is available to a kidney lobe is there is an obstruction
3 factors controlling constriction in the arterioles
local autoregulation, the SNS, and the renin-angiotensin mechanism
autoregulation of arterioles
these are small, local reflex adjustments in the diameter of the arterioles made in response to minor change in blood flow in the kidneys
blood pressure and renal disease
BP is typically elevated
ex. of a renin-blocking drug
beta-adrenergic blocking drugs
why is urine flow often obstructed in older men?
due to hypertrophy of the prostate
incontinence
is the loss of voluntary control of the bladder
causes of incontinence
diabetes, pregnancy or childbirth, overactive bladder, enlarged prostate, weak bladder muscles, UTIs, diseases like parkinson’s or multiple sclerosis, spinal cord injuries, or severe constipation
enuresis
is involuntary urination by a child after age 4-5 when bladder control is expected, most children only have this at night
factors causing enuresis
developmental delays, sleep patterns, or psychosocial aspects
stress incontinence
occurs when increased intraabdominal pressure forces urine through the sphincter and this can occur with coughing, lifting, or laughing
overflow incontinence
results from an incompetent bladder sphincter, causing a dribble or leak of urine
spinal cord injuries and miturication
can cause flaccid or spastic bladder due to interference with the CNS and ANS; if the injury is at the sacral level, retention may occur
retention
is an inability to empty the bladder and may be accompanied by overflow incontinence; this is common after anesthesia
catheter
is a tube inserted in the urethra that drains urine from the bladder to a collecting bag outside the body; this prevent kidney damage but commonly cause infections
cloudy urine
may indicate large presence of protein, blood cells, bacteria, or pus
dark coloured urine
may indicate hematuria, excessive bilirubin content, or highly concentrated urine
hematuria
blood in urine
unpleasant odor urine
may indicate infection or result from certain foods or medications
what is hematuria associated with?
infection, inflammation, or tumors in the urinary tract; gross hematuria (large number of RBCs) may indicate increased glomerular permeability or hemorrhage
proteinuria
indicates the leakage of mixed plasma proteins into the filtrate owing to inflammation and increased glomerular permeability; albuminuria refers to albumin
bacteriuria or pyuria
indicates infection in the urinary tract; pyuria is pus
urinary casts
are microscopic molds on the tubules, consisting of one or more cells, bacteria, protein, etc. and these indicated inflammation of the kidney tubules
low specific gravity of urine
usually is related to renal failure (assuming normal dehydration)
what is found in the urine when diabetes mellitus is not controlled well?
glucose and ketones
what in the urine signifies a failure to excrete nitrogenous wastes?
urea and creatinine and these are attributed to decreased GFR
what in the urine signifies metabolic acidosis?
low pH and low HCO3- and this indicates decreased GFR and failure of the tubules to control the acid-base balance
what in the urine signifies bone marrow depression?
low hemoglobin
what in the urine signifies decreased erythropoietin secretion?
low hemoglobin
what in the urine may be used for a diagnosis of postreptococcal glomerulonephritis?
antibody levels of antistreptolysin O or antistreptokinase
what do high renin levels indicate?
hypertension
what is used to asses GFR?
clearance tests like creatinine or inulin clearance or radioisotope studies
what can be used to visualize the structures and any abnormalities of the urinary system?
radiologic tests, angiography, ultrasound, CT, MRI, and intravenous pyelography
cystoscopy
visualizes the lower urinary tract and may be used in performing a biopsy or removing kidney stones
diuretics
are “water pills” used to remove excess sodium ions and water from the body, therefore increasing the excretion of water, also causes edema to decrease
what are diuretics commonly prescribed for?
hypertension, edema, CHF, liver disease, and pulmonary edema
most common action of diuretics and 2 examples
inhibit NaCl reabsorption; ex. hydrochlorothiazide and furosemide
major side effects of diuretics
excessive loss of electrolytes which may cause muscle weakness or cardiac arrhythmias
what is important to replace when taking diuretics?
potassium and other electrolytes
example of a potassium sparing diuretic
spironolactone; this is often taking in combination with thiazides
hydrochlorothiazide
inhibits reabsorption of Na+ and H20 in DCT; it helps with hypertension, CHF, and edema
furosemide
decreases reabsorption of Na+ and H20 in PCT, loop of henle, and the DCT; it works with hypertension, CHF, edema, renal disease, and liver disease
spironolactone
is an aldosterone antagonist and blocks reabsorption of Na+ and K+ in the DCT; it works for CHF, hypertension, and liver disease
acetazolamide
carbonic anhydrase inhibitor that blocks reabsorption of Na+ and secretion of H+; is used for CHF and glaucoma
example of a thiazide type drug
hydrochlorothiazide
example of a loop diuretic
furosemide
example of a potassium sparing diuretic
spironolactone
mannitol
is given intravenous and increases osmotic pressure and water in the filtrate and reduces Na+ reabsorption; is used for cerebral edema and glaucoma
example of an osmotic diuretic
mannitol
risks of diuretics
xerostomia (dry mouth), dental caries, dizziness, and orthostatic hypotension
dialysis
provides an artificial kidney which can be used to sustain life after the kidneys fail
how much kidney do you need to survive?
half of one
who is dialysis used for?
to treat someone who has acute renal failure, for those in end-stage renal failure until a transplant is available, or those experiencing rejection from a transplant
what is restricted for those with dialysis?
diet, protein, fluid intake, and electrolytes
two forms of dialysis
hemodialysis and peritoneal dialysis
hemodialysis
is provided in a hospital, dialysis center, or home with special equipment; the patients blood usually from the arm is attached to a machine where the exchange of wastes, fluid, and electrolytes takes place
what separates the patients blood from the dialysis fluid in a hemodialysis?
a semipermeable membrane
dialysate
the dialysis fluid
how often does hemodialysis take place?
three times a week for sessions about 3-4 hours
potential complications of dialysis
infected shunt, blood clots, and a risk for hep B, C, or HIV; peritonitis is a risk for peritoneal dialysis
peritoneal dialysis
is administered in a dialysis unit or at home, in which a catheter is implanted in the peritoneal cavity, allowing for the exchange of wastes and electrolytes to occur here
what serves as the exchange membrane in peritoneal dialysis?
the peritoneal membrane
is hemodialysis or peritoneal dialysis longer?
peritoneal
