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URINARY DISORDERS

URINARY DISORDERS. CHEMICAL CONTROL OF URINARY SYSTEM. Reabsorption of H2O in distal convoluted tubule controlled by ADH (antidiuretic hormone) – hormone makes collecting tubules more permeable to water ADH known as the “water-retaining hormone”

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URINARY DISORDERS

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  1. URINARY DISORDERS

  2. CHEMICAL CONTROL OF URINARY SYSTEM • Reabsorption of H2O in distal convoluted tubule controlled by ADH (antidiuretic hormone) – hormone makes collecting tubules more permeable to water • ADH known as the “water-retaining hormone” • Secretion and regulation of ADH is controlled by the pituitary gland in the hypothalamus • ALDOSTERONE – secreted by the adrenal cortex, promotes excretion of potassium and hydrogen ions and reaborption of sodium, chlorine ions and H20 ADRENAL GLANDS

  3. CHEMICAL CONTROL OF THE URINARY SYSTEM • RENIN –hormone released by kidneys, stimulates release of aldosterone from adrenal cortex • DIURETICS inhibit reabsorption of H2O • Lasix –well known diurectic that acts on the Loop of Henle to block reabsorption

  4. NERVOUS CONTROL OF THE URINARY SYSTEM • Direct control through nerve impulses on the kidney blood vessels • Indirect control through stimulation of endocrine glands

  5. ACUTE KIDNEY FAILURE • Rapid decline in kidney function • Caused by a variety of factors that alter blood pressure or affect glomerular filtration such as nephritis, shock, injury, bleeding, sudden heart failure or poisoning • Symptoms – OLIGURIA OR ANURIA

  6. ACUTE RENAL FAILURE • Suppression of urine formation can lead to UREMIA – toxic condition when blood retains urinary waste products • Concentration of nitrogenous waste is assessed by the Blood Urea Nitrogen (BUN) • Urea is produced by the breakdown of protein already in the body and protein in your diet • Normal BUN is 7 – 20 mg/dL in adults and 5 – 18 mg/dL in children • A high BUN usually means the kidney function is less than normal

  7. CHRONIC RENAL FAILURE • Gradual loss of function of nephrons • Stage I – Some nephrons are lost but others compensate by enlarging and taking over (BUN is normal) • Stage II – called renal insuffiency – remaining nephrons can’t handle urea load and BUN climbs – also have polyruria and dehydration • Stage III – called uremia – very high BUN due to loss of kidney function – fluids retained by the body so get hypertension and edema – need kidney transplant

  8. GLOMERULONEPHRITIS • Inflammation of the glomerulus • Filtration process affected • Plasma proteins are filtered through and found in urine, RBCs too (HEMATURIA) • Can be acute or chronic • Acute is caused by a delayed immune response (1 – 6 weeks) to a streptococcal infection – most common form of kidney disease • Chronic – there is permanent damage

  9. PYELONEPHRITIS • Literally “pelvis nephritis” and refers to inflammation of the renal pelvis and connective tissue of the kidney • Usually caused by infection from ureters or bladder • Symptoms – fever, chills, pain in the sides, nausea and an urge to urinate frequently • Another symptom is PYURIA (pus in urine) – yellow streaks seen in the medulla indicate tubules filled with pus • Rx - antibiotics

  10. HYDRONEPHROSIS • Urine backs up because of blockage in ureter and renal pelvis and calcyes become distended • Can be due to kidney stone • Can also be caused by pregnancy and enlarge prostrate • Rx – Remove the cause

  11. RENAL CALCULI (Kidney Stone) • Develop in the renal pelvis or calcyes (under reanl pyamids) • Made of crystals of calcium phosphate and uric acid • Gradually they grow larger until they block the ureter – small ones may pass through • First symptom – severe pain • Other symptoms – nausea and vomiting, urine frequency, chills, fever, and hematuria

  12. RENAL CALCULI (KIDNEY STONES • Diagnosis – by symptoms, utlrasound, or x-ray (IVP – intravenous polygram or KUB) • Rx – increase fluids to flush out stones, medications, and if needed - LITHOTRIPSY

  13. LITHROTRIPSY Surgical procedure to remove kidney stones Shock waves hit dense stones and break them up Done on outpatient basis

  14. Cystitis • Inflammation of the mucous membrane lining of the urinary bladder • Most common cause – E.Coli • Symps = DYSURIA (painful urination) and frequency • Usually in females (shorter urethra) • Rx - antibiotics

  15. Incontinence • Involuntary urination

  16. Dialysis • Used for kidney failure • Involves the passage of blood through a device with semipermeable membrane • Dialysis serves as a substitute kidney

  17. Hemodialysis • Blood from patient flows through machine and its filtered • Usually a FISTULA is created (opening between vein and artery) for inserting needles • Can be done at home or in clinic • Takes 2-4 hours, 2-3 times a week

  18. Peritoneal Dialysis • Uses the peritoneal lining to filter blood • Dialysate (cleaning solution) flows in and out via a catheter tube

  19. Kidney Transplant • Done as a last resort • Involves donor organ from someone with a similar immune system • Main complication - rejection

  20. Urinary Conditions ENURESIS - bedwetting GLYCOSURIA – sugar in urine NOCTURIA – frequent urination at night Hematuria – blood in urine

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