The Kidney and renal tract Flashcards
Kidney function
Filters 180L fluid daily - reabsorbs 178L - excretes 2L
70% body is water
Clear waste
Balance acid/base
Produce hormones:
Control blood pressure - renin
Help to make blood cells erythropoietin
Regulate bone health - Ca, P, vit D - produced in skin and liver and processed in kidneys
Functioning unit
First part
Function
What happens to filtrate
Nephron
Glomerulus
retains proteins and blood cells and allows fluid component through
Processed by tubules
Filtrate
Largely absorbed by proximal convoluted tubule
Passes through segment called LoH (very conc)
Passes through cortical and medullary collecting duct
Around 1000000 nephrons in each kidney
Kidney dysfunction - salt and water homeostasis
What will dysfunction affect/result in
Dysuria
Hypo/hypertension
Changes in total body water
Kidney dysfunction - excretion of waste products
What will dysfunction affect/result in
Uraemia - excess urea from metabolic breakdown of proteins
Acidosis e.g lactic acid, ketoacids
Other - potassium, phosphate, uric acid
Drug clearance
Kidney dysfunction - humoral disturbance
What will dysfunction affect/result in
Anaemia
Renal bone disease
Hypertension
Kidney dysfunction - barrier failure
What will dysfunction affect/result in
Haematuria
Proteinuria
Lipiduria
Classification of chronic kidney disease
GFR
GFR - ml/minute
1 Kidney damage (structural/urinary/other) and Normal GFR >90
2 Mildly reduced renal function 60-89
3 Moderately reduced renal function 30-59
4 Severely reduced renal function 15-29
5 Very severe to End-stage Kidney Failure <15
May require dialysis/transplantation
Treatment of chronic kidney disease - mild/moderate
Diet/fluid balance
Supplements - alkali, vitamin D, iron
Drugs - phosphate, hypertension, anaemia
Specific conditions - immunosuppression
Treatment of chronic kidney disease - severe
Dialysis - fistula is created as passage between vein and artery
Bleeding, infection, death, air embolism - pulmonary circulation blocked
Transplantation
Uncontrolled hypertension
Myocardial infarction
Haemorrhages in the retina
Renal bone disease
Renal osteodystrophy
Osteoporosis of bones
Periosteal erosions
Red cell fragments as red cells break up more easily
Peritoneal dialysis
4x a day
Not as efficient as haemodialysis
Clinical syndromes
Acute renal failure Chronic renal failure Nephrotic syndrome (proteinuria) Nephritic syndrome (haematuria) Malignant hypertension (accelerated phase)
Primary cause of renal failure
<65
> 65
Glomerulonephritis Pyelonephritis - disease of tubules Polycystic kidney disease Hypertension Diabetes
