Week 15: Urinary system Flashcards
Urinary System: Review
- Removes metabolic ________
- Removes ____________ from the body
- Removes drugs other foreign material from body
- Regulates water, electrolyte, acid-base balance
- Secretes erythropoietin
- Activates vitamin D
- Regulate _______________ through the renin-angiotensin-aldosterone system
- Removes metabolic wastes
- Removes hormones from the body
- Removes drugs other foreign material from body
- Regulates water, electrolyte, acid-base balance
- Secretes erythropoietin
- Activates vitamin D
- Regulate blood pressure through the renin-angiotensin-aldosterone system
Kidneys
↓
Ureters
↓
_____________
↓
Urethra
Kidneys
↓
Ureters
↓
Urinary bladder
↓
Urethra
Nephrons—functional units of the kidneys
Each kidney has over ___________ nephrons.
Renal ____________
- Glomerulus
- Bowman capsule
Renal __________
- Proximal convoluted tubules
- Loop of Henle
- Distal convoluted tubules
- Collecting duct
Each kidney has over a million nephrons.
Renal corpuscles
- Glomerulus
- Bowman capsule
Renal tubules
- Proximal convoluted tubules
- Loop of Henle
- Distal convoluted tubules
- Collecting duct
Filtration
-In renal ____________
-Large volume of fluid passes from glomerular ___________ into the tubule (Bowman capsule)
-In renal corpuscles
-Large volume of fluid passes from glomerular capillaries into the tubule (Bowman capsule)
Reabsorption
Transport mechanisms for reabsorption
- ________ transport
- Co-transport
- Osmosis—water
Proximal convoluted tubules
-Most of water ______________
- Glucose reabsorption
- Nutrients and electrolytes to maintain homeostasis
Transport mechanisms for reabsorption
- Active transport
- Co-transport
- Osmosis—water
Proximal convoluted tubules
-Most of water reabsorption
- Glucose reabsorption
- Nutrients and electrolytes to maintain homeostasis
Hormones Involved in reabsorption
- ___________ hormone (ADH)
- Aldosterone
- ________ natriuretic hormone
- Antidiuretic hormone (ADH)
- Aldosterone
- Atrial natriuretic hormone
Blood Flow through the Kidney - Specialized pattern:
Renal ________ → interlobar artery → arcuate artery → interlobular artery → afferent arteriole
→ glomerular ______________ → efferent arteriole → peritubular capillaries → interlobular vein → arcuate vein → interlobar vein → renal _______
Renal artery → interlobar artery → arcuate artery → interlobular artery → afferent arteriole
→ glomerular capillaries → efferent arteriole → peritubular capillaries → interlobular vein →
arcuate vein → interlobar vein → renal vein
Glomerular Filtration Rate - control of arteriolar constriction by three factors:
____________
- Local adjustment in diameter of arterioles
- Made in response to changes in blood flow in kidneys
_____________ nervous system
- Increases vasoconstriction in both arterioles
____________
- Secreted by juxtaglomerular cells when blood flow to afferent arteriole is reduced
- Renin-angiotensin mechanism
Autoregulation
- Local adjustment in diameter of arterioles
- Made in response to changes in blood flow in kidneys
Sympathetic nervous system
- Increases vasoconstriction in both arterioles
Renin
- Secreted by juxtaglomerular cells when blood flow to afferent arteriole is reduced
- Renin-angiotensin mechanism
Retention
- Inability to ___________ bladder
- May be accompanied by overflow incontinence
- Spinal cord injury at sacral level blocks micturition reflex
- May follow anesthesia (general or spinal)
- Inability to empty bladder
- May be accompanied by overflow incontinence
- Spinal cord injury at sacral level blocks micturition reflex
- May follow anesthesia (general or spinal)
Urinalysis: Urinary Infection
- Heavy purulence and presence of _______________________________ organisms
gram-negative and gram-positive
Urinalysis: Abnormal Constituents of Urine
- _______ (hematuria)
- Elevated _________ level (proteinuria, albuminuria)
- _________ (bacteriuria)
- Blood (hematuria)
- Elevated protein level (proteinuria, albuminuria)
- Bacteria (bacteriuria)
Urinary casts
- Indicate inflammation of ______________
Specific gravity
- Indicates ability of tubules to ____________ urine
- Low specific gravity—dilute urine (with normal hydration)
- High specific gravity—concentrated urine (with normal hydration)
- Related to renal failure
Glucose and ketones
- Found when _____________ mellitus is not well controlled
Urinary casts
- Indicate inflammation of kidney tubules
Specific gravity
- Indicates ability of tubules to concentrate urine
- Low specific gravity—dilute urine (with normal hydration)
- High specific gravity—concentrated urine (with normal hydration)
- Related to renal failure
Glucose and ketones
- Found when diabetes mellitus is not well controlled
Elevated renin levels Indicate _______ as a cause of hypertension
kidney
Diuretic Drugs
- Used to remove excess _________ ions and _______ from the body
- Increased excretion of water though the kidneys
- Reduces fluid volume in tissues and blood
- Prescribed for many disorders
-Renal disease, hypertension, edema, congestive heart failure, liver disease, pulmonary edema
- Several different mechanisms to increase urine _________ based on specific drug
- Some drugs are potassium-wasting and some are potassium-sparing.
- Used to remove excess sodium ions and water from the body
- Increased excretion of water though the kidneys
- Reduces fluid volume in tissues and blood
- Prescribed for many disorders
-Renal disease, hypertension, edema, congestive heart failure, liver disease, pulmonary edema - Several different mechanisms to increase urine volume based on specific drug
- Some drugs are potassium-wasting and some are potassium-sparing.
Dialysis
-Provides ____________ and reabsorption
Two forms
- Hemodialysis
-Peritoneal dialysis
- Sustains life during __________ failure
-Used to treat patients with acute kidney failure - For patients in end-stage renal failure
Dialysis
-Provides filtration and reabsorption
Two forms
- Hemodialysis
-Peritoneal dialysis
- Sustains life during kidney failure
-Used to treat patients with acute kidney failure - For patients in end-stage renal failure
Hemodialysis
- In hospital, dialysis center, or home with special equipment and training
- Patient’s blood moves from an implanted shunt or catheter in an artery to ____________
- Exchange of wastes, fluids, and electrolytes
- Semipermeable membrane between blood and dialysis fluid (dialysate)
-Blood cells and proteins remain in blood.
- After exchange is completed, blood returned to _________________
- In hospital, dialysis center, or home with special equipment and training
- Patient’s blood moves from an implanted shunt or catheter in an artery to machine
- Exchange of wastes, fluids, and electrolytes
- Semipermeable membrane between blood and dialysis fluid (dialysate)
-Blood cells and proteins remain in blood. - After exchange is completed, blood returned to patient’s vein
Hemodialysis (Cont.)
- Usually required ______ times a week
- Each lasts about 3 to 4 hours.
Potential complications
- Shunt may become infected.
- Blood ______ may form.
- Blood vessels involved in shunt may become sclerosed or damaged.
-Patient has an increased risk of infection with hepatitis B, hepatitis C, or HIV if Standard Precautions are not followed.
- Usually required three times a week
- Each lasts about 3 to 4 hours.
Potential complications
- Shunt may become infected.
- Blood clots may form.
- Blood vessels involved in shunt may become sclerosed or damaged.
-Patient has an increased risk of infection with hepatitis B, hepatitis C, or HIV if Standard Precautions are not followed.
Peritoneal Dialysis
- Usually done on outpatient basis
- Peritoneal membrane serves as the semipermeable membrane.
- Catheter with entry and exit points is implanted into the __________________
- Dialyzing fluid is instilled into cavity
- Dialysate is drained from cavity via gravity into container
- Usually done on outpatient basis
- Peritoneal membrane serves as the semipermeable membrane.
- Catheter with entry and exit points is implanted into the peritoneal cavity
- Dialyzing fluid is instilled into cavity
- Dialysate is drained from cavity via gravity into container
Peritoneal Dialysis (Cont.)
- Takes more _____ than hemodialysis
- Requires loose clothing to accommodate bag of fluid
- Major complication - ___________ resulting in peritonitis - With both types of dialysis
- Takes more time than hemodialysis
- Requires loose clothing to accommodate bag of fluid
- Major complication - Infection resulting in peritonitis - With both types of dialysis
Urinary Tract Infections (UTIs)
- Very common infections
- Urine is an excellent ________ medium.
Lower urinary tract infections
- Cystitis
- Urethritis
Upper urinary tract infections
- Pyelonephritis
Common causative organism
_____________
Urinary Tract Infections (UTIs)
- Very common infections
- Urine is an excellent growth medium.
Lower urinary tract infections
- Cystitis
- Urethritis
Upper urinary tract infections
- Pyelonephritis
Common causative organism
- Escherichia coli
Urinary Tract Infections (UTIs) (Cont.)
More common in women because of:
- Shortness of _________
-Proximity to ______
Older men
- Prostatic hypertrophy
- Urine retention
Congenital abnormalities in children
Other common predisposing factors
- Incontinence
-Retention of urine
- Direct contamination with fecal material
More common in women because of:
- Shortness of urethra
-Proximity to anus
Older men
- Prostatic hypertrophy
- Urine retention
Congenital abnormalities in children
Other common predisposing factors
- Incontinence
-Retention of urine
- Direct contamination with fecal material
Cystitis and Urethritis
-Bladder wall (cystitis) and urethra (urethritis) are _________.
- _____________ bladder and reduced capacity
-Pain is common in pelvic area
- Dysuria, urgency, frequency, and nocturia
-Systemic signs may be present.
- Fever, malaise, nausea, leukocytosis
- Urine often _________, with unusual odor
- Urinalysis indicates bacteriuria, pyuria, microscopic hematuria
More common in women because of:
- Shortness of urethra
-Proximity to anus
Older men
- Prostatic hypertrophy
- Urine retention
Congenital abnormalities in children
Other common predisposing factors
- Incontinence
-Retention of urine
- Direct contamination with fecal material
Pyelonephritis
- One or both kidneys involved
- From ureter into kidney
- Purulent __________ fills pelvis and calyces
- Recurrent or chronic infection can lead to scar tissue formation.
- One or both kidneys involved
- From ureter into kidney
- Purulent exudate fills pelvis and calyces
- Recurrent or chronic infection can lead to scar tissue formation.
Pyelonephritis (Cont.)
- Signs of cystitis plus pain associated with renal disease
- Dull, aching pain in lower _____ or flank area
- Systemic signs include high temperature
Urinalysis
- Similar to cystitis
- Urinary _____ are present.
- Reflection of renal tubule involvement
- Treatment with antibacterials
- Signs of cystitis plus pain associated with renal disease
- Dull, aching pain in lower back or flank area
- Systemic signs include high temperature
Urinalysis
- Similar to cystitis
- Urinary casts are present.
- Reflection of renal tubule involvement
- Treatment with antibacterials
Inflammatory Disorders: Glomerulonephritis
-Many forms
Presence of antistreptococcal (ASO) _________
- Formation of an antigen-antibody complex
- Activates complement system
- Inflammatory response in glomeruli
- Severe ______________ response - Congestion and cell proliferation
Presence of antistreptococcal (ASO) antibodies
- Formation of an antigen-antibody complex
- Activates complement system
- Inflammatory response in glomeruli
- Severe inflammatory response - Congestion and cell proliferation
Inflammatory Disorders—Glomerulonephritis (Cont.)
- Urine becomes _____ and cloudy
- Facial and periorbital _______ —initially
- General edema follows
- Elevated blood pressure
-Caused by increased ______ secretion and decreased GFR
- Flank or back pain
- Edema and stretching of renal capsule
- General signs of inflammation
- Decreased urine output
- Urine becomes dark and cloudy
- Facial and periorbital edema—initially
- General edema follows
- Elevated blood pressure
-Caused by increased renin secretion and decreased GFR - Flank or back pain
- Edema and stretching of renal capsule
- General signs of inflammation
- Decreased urine output
Inflammatory Disorders: Glomerulonephritis Treatment
- Sodium restriction possible
- Protein and fluid intake decreased in severe cases
- Drug treatment
- ____________ to reduce inflammation
- Antihypertensives
- Sodium restriction possible
- Protein and fluid intake decreased in severe cases
- Drug treatment
- Glucocorticoids to reduce inflammation
- Antihypertensives
Inflammatory Disorders: Nephrotic Syndrome
- Abnormality in ______________________ , increased permeability, large amounts of plasma proteins escape into filtrate
- May be idiopathic in children 2 to 6 years old
- May be secondary to SLE, exposure to nephrotoxins or drugs
- Abnormality in glomerular capillaries, increased permeability, large amounts of plasma proteins escape into filtrate
- May be idiopathic in children 2 to 6 years old
- May be secondary to SLE, exposure to nephrotoxins or drugs
Nephrotic Syndrome: Pathophysiology
- Hypoalbuminemia with decreased plasma osmotic pressure
- Subsequent generalized edema
-Blood pressure remains low or normal.
- May be elevated depending on angiotensin II levels
-Increased ___________ secretion in response to reduced blood volume
-More severe edema
-High blood cholesterol, lipoprotein in urine, lipiduria with milky appearance to urine
- Hypoalbuminemia with decreased plasma osmotic pressure
- Subsequent generalized edema
-Blood pressure remains low or normal. - May be elevated depending on angiotensin II levels
-Increased aldosterone secretion in response to reduced blood volume
-More severe edema
-High blood cholesterol, lipoprotein in urine, lipiduria with milky appearance to urine
Inflammatory Disorders: Nephrotic Syndrome (Cont.)
Treatment
- ____________ to reduce inflammation
- ACE inhibitors may decrease protein loss in urine
- Antihypertensives
- ________ intake may be restricted.
- Glucocorticoids to reduce inflammation
- ACE inhibitors may decrease protein loss in urine
- Antihypertensives
-Sodium intake may be restricted.
Urolithiasis (Calculi)
- Can develop anywhere in _______ tract
- Stones may be small or very large.
- Tend to form with:
- Manifestations only occur with obstruction of urine flow.
-May lead to infection
- Hydronephrosis with dilation of calyces
- If located in kidney or ureter and atrophy of renal tissue
- Can develop anywhere in urinary tract
- Stones may be small or very large.
- Tend to form with:
- Manifestations only occur with obstruction of urine flow.
-May lead to infection - Hydronephrosis with dilation of calyces
- If located in kidney or ureter and atrophy of renal tissue
Urolithiasis (Calculi) (Cont.)
- Calculi composed of _______ salts
- High urine calcium levels
-Form readily with highly alkaline urine
- Uric acid stones
- Hyperuricemia
- Gout, high-purine diets, cancer chemotherapy
- Especially with acidic urine
- Struvite and cystine stones
- Stone formation depends on predisposing factor
- Calculi composed of calcium salts
- High urine calcium levels
-Form readily with highly alkaline urine - Uric acid stones
- Hyperuricemia
- Gout, high-purine diets, cancer chemotherapy
- Especially with acidic urine
- Struvite and cystine stones
- Stone formation depends on predisposing factor
Urolithiasis (Calculi) (Cont.)
- Stones in kidney or bladder often asymptomatic
- Frequent infections may lead to investigation.
- Flank pain possible caused by distention of renal capsule
- Renal colic caused by ________ of the ureter
- Intense spasms of pain in flank area
- Possible nausea and vomiting, cool moist skin, rapid pulse
- Radiological examination confirms _________ of calculi
- Stones in kidney or bladder often asymptomatic
- Frequent infections may lead to investigation.
- Flank pain possible caused by distention of renal capsule
- Renal colic caused by obstruction of the ureter
- Intense spasms of pain in flank area
- Possible nausea and vomiting, cool moist skin, rapid pulse
- Radiological examination confirms location of calculi
Urolithiasis (Calculi) (Cont.)
Treatment
-Small stones will be ________ eventually.
- Extracorporeal shock wave lithotripsy (ESWL)
- Laser lithotripsy
- Drugs may be used to ________ stones partially.
- Surgery
Prevention
- Treatment of underlying condition
- Adjustment of urine pH through _________ modifications
- Consistent increased fluid intake
Treatment
-Small stones will be passed eventually.
- Extracorporeal shock wave lithotripsy (ESWL)
- Laser lithotripsy
- Drugs may be used to dissolve stones partially.
- Surgery
Prevention
- Treatment of underlying condition
- Adjustment of urine pH through dietary modifications
- Consistent increased fluid intake
Tumors: Renal Cell Carcinoma
- Primary tumor arising from the tubule epithelium
- More often in renal cortex
- Tends to symptomatic in early stages
- Often has metastasized to liver, lung, bone, or CNS at time of diagnosis
- Occurs more frequently in men and smokers
- Treatment is _______________ .
- Immunotherapy may be used in some cases.
- Tumor is radioresistant, and chemotherapy is not used in most cases
- Primary tumor arising from the tubule epithelium
- More often in renal cortex
- Tends to symptomatic in early stages
- Often has metastasized to liver, lung, bone, or CNS at time of diagnosis
- Occurs more frequently in men and smokers
- Treatment is removal of kidney.
- Immunotherapy may be used in some cases.
- Tumor is radioresistant, and chemotherapy is not used in most cases
Tumors: Renal Cell Carcinoma Manifestations
- Painless _________ initially
- Gross or microscopic
- Dull, aching flank pain
- Palpable mass
- Unexplained weight loss
- Anemia or erythrocytosis
- Paraneoplastic syndromes
- Hypercalcemia or Cushing’s syndrome
- Painless hematuria initially
- Gross or microscopic
- Dull, aching flank pain
- Palpable mass
- Unexplained weight loss
- Anemia or erythrocytosis
- Paraneoplastic syndromes
- Hypercalcemia or Cushing’s syndrome
Tumors: Bladder Cancer
- Most bladder tumors are ___________ & commonly arise from transitional epithelium of bladder.
- Often develops as multiple tumors
- Diagnosed by urine cytology and biopsy
Early signs
- Hematuria, dysuria
- Infection common
Tumor is invasive through wall to adjacent structures.
- Metastasizes to pelvic lymph nodes, liver, and bone
- Most bladder tumors are malignant & commonly arise from transitional epithelium of bladder.
- Often develops as multiple tumors
- Diagnosed by urine cytology and biopsy
Tumors: Bladder Cancer (Cont.)
Predisposing factors
- Working with __________ in laboratories and industry
- Particularly aniline dyes, rubber, aluminum
- ________ smoking
- Recurrent infections
- Heavy intake of _________
Treatment
- Surgical resection of tumor
- Chemotherapy and radiation
- Photoradiation successful in some early cases
Predisposing factors
- Working with chemicals in laboratories and industry
- Particularly aniline dyes, rubber, aluminum
- Cigarette smoking
- Recurrent infections
- Heavy intake of analgesics
Treatment
- Surgical resection of tumor
- Chemotherapy and radiation
- Photoradiation successful in some early cases
Vascular Disorders: Nephrosclerosis
Involves ________ changes in the kidney
- Some occur normally with aging.
Thickening and __________ of the walls of arterioles and small arteries
Narrowing of the blood vessel lumen
- Reduction of ______ supply to kidney
- Stimulation of renin
- Increased blood pressure
Continued ischemia
- Destruction of renal ________
- Chronic renal failure
Involves vascular changes in the kidney
- Some occur normally with aging.
Thickening and hardening of the walls of arterioles and small arteries
Narrowing of the blood vessel lumen
- Reduction of blood supply to kidney
- Stimulation of renin
- Increased blood pressure
Continued ischemia
- Destruction of renal tissue
- Chronic renal failure
Nephrosclerosis (Cont.)
- Can be primary _______ developed in kidney
- May be secondary to essential hypertension
Treatment
- ___________ agents
- Diuretics
- Beta blockers
- ________ intake should be reduced.
- Can be primary lesion developed in kidney
- May be secondary to essential hypertension
Treatment
- Antihypertensive agents
- Diuretics
- Beta blockers
- Sodium intake should be reduced.
Congenital Disorders
- Vesicoureteral reflux
Agenesis
-Failure of one kidney to ________
Hypoplasia
- Failure to develop to normal _____
Ectopic kidney
- Kidney and ureter displaced out of normal position
“Horseshoe” kidney
- _________ of the two kidneys
Congenital Disorders
- Vesicoureteral reflux
Agenesis
-Failure of one kidney to develop
Hypoplasia
- Failure to develop to normal size
Ectopic kidney
- Kidney and ureter displaced out of normal position
“Horseshoe” kidney
- Fusion of the two kidneys
Adult Polycystic Kidney
- Autosomal dominant gene on chromosome 16
-No indications in child and young adults
- First manifestations usually around age 40 years
- Multiple cysts develop in both kidneys.
- Enlargement of kidneys
-Compression and destruction of kidney tissue
- Chronic renal failure
- Diagnosis by abdominal CT scanning or MRI
- Autosomal dominant gene on chromosome 16
-No indications in child and young adults - First manifestations usually around age 40 years
- Multiple cysts develop in both kidneys.
- Enlargement of kidneys
-Compression and destruction of kidney tissue - Chronic renal failure
- Diagnosis by abdominal CT scanning or MRI
Wilms’ Tumor
-Most common tumor in ________
- Defects in tumor suppressor genes on chromosome ____
- May occur in conjunction with other congenital disorders
- Usually unilateral
- Large encapsulated mass
- Pulmonary metastases may be present at diagnosis.
-Most common tumor in children
- Defects in tumor suppressor genes on chromosome 11
- May occur in conjunction with other congenital disorders
- Usually unilateral
- Large encapsulated mass
- Pulmonary metastases may be present at diagnosis.
Acute Renal Failure Causes
- Acute bilateral kidney diseases
- Severe, prolonged circulatory shock or heart failure
- ___________
- Drugs, chemicals, or toxins
-Mechanical __________ (occasionally)
- Calculi, blood clots, tumors
- Block urine flow beyond kidneys
- Acute bilateral kidney diseases
- Severe, prolonged circulatory shock or heart failure
-Nephrotoxins - Drugs, chemicals, or toxins
-Mechanical obstruction (occasionally) - Calculi, blood clots, tumors
- Block urine flow beyond kidneys
Acute Renal Failure (Cont.)
-Sudden onset
Blood tests
- Elevated serum urea nitrogen and creatinine levels
- Metabolic acidosis and hyperkalemia
Treatment
- Identify and remove or treat primary problem to minimize risk of necrosis and permanent kidney damage
- ________ to normalize body fluids and maintain homeostasis
Blood tests
- Elevated serum urea nitrogen and creatinine levels
- Metabolic acidosis and hyperkalemia
Treatment
- Identify and remove or treat primary problem to minimize risk of necrosis and permanent kidney damage
- Dialysis to normalize body fluids and maintain homeostasis
Chronic Renal Failure
-Gradual ____________ destruction of the kidneys over a long period of time
-Asymptomatic in early stages
May result from
- Chronic __________ disease
-Congenital polycystic kidney disease
- Systemic disorders
- Low-level exposure to nephrotoxins over sustained period of time
-Gradual irreversible destruction of the kidneys over a long period of time
-Asymptomatic in early stages
May result from
- Chronic kidney disease
-Congenital polycystic kidney disease
- Systemic disorders
- Low-level exposure to nephrotoxins over sustained period of time
Chronic Renal Failure: Stages
Decreased renal reserve
- Decrease in ______
- Higher than normal serum creatinine levels
- No apparent clinical symptoms
Renal insufficiency
- Decreased GFR to about 20% of normal
- Significant retention of nitrogen wastes
- Excretion of large volumes of dilute urine
- Decreased erythropoiesis
- Elevated blood pressure
End-stage renal failure
- Negligible ______
- Fluid, electrolytes, and wastes ___________ in body
-Azotemia, anemia, and acidosis (three As)
- All body systems affected
- Marked oliguria or anuria
- Regular dialysis or kidney transplantation
- To maintain patient’s life
Decreased renal reserve
- Decrease in GFR
- Higher than normal serum creatinine levels
- No apparent clinical symptoms
Renal insufficiency
- Decreased GFR to about 20% of normal
- Significant retention of nitrogen wastes
- Excretion of large volumes of dilute urine
- Decreased erythropoiesis
- Elevated blood pressure
End-stage renal failure
- Negligible GFR
- Fluid, electrolytes, and wastes retained in body
-Azotemia, anemia, and acidosis (three As)
- All body systems affected
- Marked oliguria or anuria
- Regular dialysis or kidney transplantation
- To maintain patient’s life
Chronic Renal Failure (Cont.)
Early signs - Increased __________ output
General signs
- Bone marrow depression and impaired cell function
- Caused by increased wastes and altered blood chemistry
- Elevated blood pressure
Complete failure
- __________
- Dry, pruritic, hyperpigmented skin, easy bruising
- Peripheral neuropathy
- Impotence in men, menstrual irregularities in women
- Encephalopathy
- Congestive ________ failure, dysrhythmias
-Failure to activate vitamin D
- Possible uremic frost on the skin
- Systemic infections
Early signs - Increased urinary output
General signs
- Bone marrow depression and impaired cell function
- Caused by increased wastes and altered blood chemistry
- Elevated blood pressure
Complete failure
- Oliguria
- Dry, pruritic, hyperpigmented skin, easy bruising
- Peripheral neuropathy
- Impotence in men, menstrual irregularities in women
- Encephalopathy
- Congestive heart failure, dysrhythmias
-Failure to activate vitamin D
- Possible uremic frost on the skin
- Systemic infections
Chronic Renal Failure (Cont.)
Diagnostic tests
- Anemia, acidosis, and azotemia are the key indicators of chronic renal failure.
Treatment—all body systems are affected.
- Difficult to maintain _______________ of fluids, electrolytes, and acid-base balance
- Drugs to stimulate erythropoiesis
- Drugs to treat cardiovascular problems
- Intake of fluid, electrolytes, protein must be ___________
- Dialysis or transplantation
Diagnostic tests
- Anemia, acidosis, and azotemia are the key indicators of chronic renal failure.
Treatment—all body systems are affected.
- Difficult to maintain homeostasis of fluids, electrolytes, and acid-base balance
- Drugs to stimulate erythropoiesis
- Drugs to treat cardiovascular problems
- Intake of fluid, electrolytes, protein must be restricted
- Dialysis or transplantation
