Transcript URINARY DISEASES

URINARY DISORDERS
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CHEMICAL CONTROL OF URINARY SYSTEM
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Reabsorption of H2O in distal
convoluted tubule controlled by
ADH (antidiuretic hormone) –
hormone makes collecting
tubules more permeable to water
 ADH known as the “waterretaining 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
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
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NERVOUS CONTROL OF
THE URINARY SYSTEM
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Direct control through
nerve impulses on the
kidney blood vessels
 Indirect control
through stimulation of
endocrine glands
ACUTE KIDNEY FAILURE
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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
ACUTE RENAL FAILURE
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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
CHRONIC RENAL FAILURE
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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
GLOMERULONEPHRITIS
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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
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PYELONEPHRITIS
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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
HYDRONEPHROSIS
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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
RENAL CALCULI (Kidney Stone)
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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
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
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if needed - LITHOTRIPSY
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LITHROTRIPSY
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Surgical procedure to remove kidney stones
 Shock waves hit dense stones and break
them up
 Done on outpatient basis
Cystitis
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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
Incontinence
 Involuntary
urination
Dialysis
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Used for kidney failure
 Involves the passage of
blood through a device
with semipermeable
membrane
 Dialysis serves as a
substitute kidney
Hemodialysis
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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
Peritoneal Dialysis
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Uses the peritoneal
lining to filter blood
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Dialysate (cleaning
solution) flows in and
out via a catheter tube
Kidney Transplant
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Done as a last resort
 Involves donor organ
from someone with a
similar immune
system
 Main complication rejection
Urinary Conditions
ENURESIS - bedwetting
NOCTURIA – frequent
urination at night
GLYCOSURIA – sugar in urine
Hematuria – blood in urine