RENAL Flashcards
renal system
kidneys, bladder, ureters, urethra
kidneys
mesenchyme; three primitive kidneys:
pronephros (disappears by 4 week GA)
mesonephros (glomeruli, mesonephric tubules and ducts, cloaca, distal portion Wolffian duct)
metanephros (proximal tubule, loop of Henle, distal convoluted tubule, collecting duct
ureters and bladder
cloacal division
urine formation and excretion begins when?
6-10 weeks GA
when is nephrogenesis complete?
full term infant 36GA; FANAROFF: 34GA
GFR
Glomerular Filtration Rate: is measured by creatinine clearance, the most consistent marker of GFR in the fetus and neonate
essential for: body fluid homeostasis, electrolyte homeostasis, elimination of drugs;
adult GFR 110-120 reached by 2 years old
postnatal 15-25
renal vasoregulators
NO, prostaglandins, ANP, sympathetic nervous system, catecholamines, RAAS
buffer system modulation
intracellular: hemoglobin, organic phosphates, bone apatite
extracellular: phosphates, plasma proteins, bicarbonate-carbonic acid system
acid base homeostasis
buffer system modulation
respiratory modulation (alveolar ventilation)
renal modulation
functions of the tubular system
reabsorption( from the lumen to the blood)
secretion (from the blood to the lumen)
transport (solute through the nephron and into the ureters for excretion as urine)
tubular transport
proximal convoluting tubule PCT
loop of Henle LOH
distal tubule DCT
collecting ducts
GENETIC ABNORMALITIES
Autosomal Dominant Polycystic Kidney Disease
Autosomal Recessive Polycystic Kidney Disease
Multicystic Dysplastic Kidney Disease
Wilms Tumor
Bartter Syndrome
maternal health influences RENAL
prematurity and LBW
GDM, smoking, alcohol, malnutrition: vit A;
drugs: ACE inhibitors and angiotensin, NSAIDs;
Acute Kidney Disease
the abrupt deterioration in renal function resulting in the inability to maintain fluid and electrolyte balance
PRERENAL (hemodynamic)
RENAL (intrinsic)
POSTNATAL (obstructive)
S&S: elevated BUN and creatinine, hyperkalemia (peaked T wave); metabolic acidosis
Congenital Hydronephrosis
abnormal accumulation of the urine within the collecting system resulting in renal cavity distention
developmental and positional anomalies RENAL
AGENESIS (absence) DYSPLASIA (errors in renal induction) HYPOPLASIA (abnormally small) HORSESHOE KIDNEY (fusion of lower poles) ureteropelvic junction obstruction posterior urethral valve disease
ureteral and urachal anomalies
renal duplication (renal duplex) patent urachus (urine backflow from bladder out to umbilicus)
total body fluids
extracellular (interstitial and plasma) and intracellular water.
75% at birth
normal weight loss at birth
10% term
15% premie
normal physiological transition process caused by atrial natriuretic peptide
glomerulotubular imbalance
physiologic state that is present when the glomerular filtration rate (GFR) exceeds the reabsorptive capacity of the renal tubules
what controls water balance
ADH antidiuretic hormone
urinary concentrating ability in preterm infant?
diminished preterm and term
urinary diluting ability in preterm infant?
diminished in preterm, normal in term
insensible water loss
GA, environmental temperature, increase body temperature; skin breakdowns, phototherapy