Kidney Problems

1. Kidney Problems

2. Introduction • The body needs the kidneys to be functioning properly in order to maintain homeostasis. • Kidneys are very connected with other body systems (i.e. Urinary System), that if one is affected, the other will be affected as well.

3. Urinalysis and Blood Tests • Urinalysis is the examination of the characteristics of urine (i.e. colour, odour, taste…). • It can give clues as to kidney function. • Blood tests can also provide info as to kidney function and make sure urea is being released.

4. Problems that affect the Kidneys

5. Urinary Tract Infections (UTIs) • UTIs are a viral or bacterial infection of the urinary tract. • Symptoms include painful urination, pain in the abdomen, fever… • If not treated with antibiotics/drugs, the infection may move up to the kidneys. • Affects females more than males.

6. Diabetes Insipidus • Not to be confused with traditional diabetes which is an inadequate supply of insulin. • Diabetes insipidus is a destruction in the ADH producing cells of the hypothalamus. • No ADH means less water reabsorbed and therefore increased urine output and massive thirst.

7. Kidney Stones • Kidney stones are caused by the precipitation of mineral salts (usually Ca) in the kidney. • Recurrent UTIs, insufficient water consumption and low activity can lead to kidney stones. • Usually pass naturally (and painfully!), but can require surgery if larger. • Also can use ultrasound (or ESWL)to blast stones into smaller pieces more easily able to pass through.

8. Nephritis (Bright’s Disease) • A broad category of diseases associated with an inflammation of the nephrons. • Usually caused by infection. • Alters the filtration of the glomerulus and thus, the formation of urine. • Various degrees of pain and thus varying degrees of treatment (i.e. skim milk treatment).

9. Renal Insufficiency • Renal insufficiency is the general term to describe a state in which kidneys’ cannot maintain homeostasis. • Nephrons can recover from short term injuries. • A person can survive with 1/3 of one kidney! • However if ~75% of the nephrons are destroyed, urine output is too low to maintain homeostasis and a kidney transplant or dialysis is required. • Causes of Renal Insufficiency: • Kidney infection • High Blood Pressure • Diabetes • Polycystic Kidney Disease (PKD) • Trauma or constant vibration • Poisoning • Atherosclerosis

10. Dialysis • Dialysis is the diffusion of dissolved substances through a semi-permeable membrane. • It is used to remove wastes and fluid from the blood when kidney function is lost to renal failure. • Substances are moved from the blood into the dialysis solution (dialysate) and vice versa. • There are two types of dialysis.

11. Hemodialysis • Hemodialysis uses an external machine with a membrane (essentially an artificial kidney) that is connected to an artery and a vein. • It removes the wastes and puts essential solutes back into the blood, like a kidney would. • Must be done 3-4 times a week and takes 3-5 hours each time.

12. Peritoneal Dialysis • Peritoneal dialysis uses the lining of the intestines (peritoneum) as the dialysis membrane. • The dialysate is put into the intestinal cavity where the large surface area and rich supply of capillaries of the peritoneum slowly filter the blood. • Then the waste is siphoned out. • It is done 3-5 times a day!

13. Kidney Transplants • Dialysis can allow a person to continue many of the daily life activities, however it is not a cure. • If a person has less than 10% of their kidney function, they will need a transplant. • Unfortunately, in Canada, the donation rate (14 per million people) is much lower than the need and so about 75% of people needing a kidney are still waiting for one. • Success rate of kidney transplants are between 95-98%. • Rejection of kidneys is becoming more rare as anti-rejection drugs and screening of donors are improving.

14. Homework • Read pages 357-362 • Questions p. 362 #1, 2, 5, 7 and 10.