Transcript Kidney Failure - North Buncombe High School

HS I
Warm up
• Urinary System Video
http://www.youtube.com/watch?v=QT5S4h
TdigU&feature=related
• Worksheet
Functions of Urinary System
• To remove waste products from the
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body.
Excretion – removing nitrogenous
wastes, certain salts and excess water
from blood.
Maintain acid-base balance
Secrete waste products in the form of
urine
Eliminate urine from bladder
KIDNEYS
• Bean-shaped organs
• Located between
peritoneum and the back
muscles
(RETROPERITONEAL)
• RENAL PELVIS – funnel
shaped structure at the
beginning of the ureter
MEDULLA
• Inner, striated
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layer
Striated cones are
RENAL PYRAMIDS
Base of each pyramid
faces cortex, while
apex empties into
cuplike cavities called
CALYCES
CORTEX
• Composed of millions
of microscopic
functional units called
nephrons
• Outer layer of the
kidney
NEPHRON
• Functional unit of the
kidney
• Parts include:
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– Bowman’s capsule (double
walled, surrounds the
glomerulus)
– Cluster of capillaries that
the Bowmans capsule
surrpounds is the
Glomerulus
– Glomerulus- filters
substances from the blood.
– Proximal convoluted tubule
– Loop of Henle
– Distal convoluted tubule
– Collecting tubule
Urine Formation in the
Nephron
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Filtration
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Reabsorption
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Secretion
FILTRATION
• First step in urine formation
• Blood from renal artery enters glomerulus
• High blood pressure in glomerulus forces fluid
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(FILTRATE) to filter into Bowman’s capsule
Filtrate does not contain plasma proteins or
RBCs – they’re too big
Bowman’s capsule filters out 125cc of fluid/min.
– 7500cc/hour
As filtrate continues through nephron, 90% of
water is reabsorbed
Production of urine is controlled by the
hormones ADH and Aldosterone
REABSORPTION
• Water and useful substances are
reabsorbed
• If blood levels of certain substances are
high (glucose, amino acids, vitamins,
sodium) then those substances will not be
reabsorbed
• Useful substances filter out of the
renal tubules and back into the
capillaries
SECRETION
• Opposite of reabsorption
• Secretion transports substances from
blood into collecting tubules
• Substances include creatinine, hydrogen
ions, potassium ions, and some drugs
• Electrolytes are selectively secreted to
maintain body’s acid-base balance
Path of the Formation of Urine
• Glomerulus
• Bowman’s Capsule
• Proximal Convoluted Tubule
• Loop of Henle
• Distal Convoluted Tubule
• Collecting Tubule
URETERS
• Connects the kidneys to the bladder.
• One from each kidney
• Carry urine from kidney to bladder
• Smooth muscle tube with mucous
membrane lining
• Peristalsis pushes urine down ureters
URINARY BLADDER
• Located in the pelvic
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cavity.
Hollow, elastic, muscular
organ
Made of elastic fibers and
involuntary muscle
Stores urine – usually
about 500cc
Emptying urine (voiding) is
involuntary but controlled
through nervous system
(voluntary)
• Urine leaves through
URETHRA to outside
opening = URINARY
MEATUS
Control of Urinary Secretion
• Chemical Control
– Reabsorption of H20 in
distal convoluted
tubule controlled by
ADH (antidiuretic
hormone)
– Secretion and
regulation of ADH
controlled by
hypothalamus
– DIURETICS inhibit
reabsorption of H20
• Nervous Control
– Direct control through
nerve impulses on
kidney blood vessels
– Indirect control though
stimulation of
endocrine glands
Processing
• Labeling activities
• Quiz 1
Warm Up
• Kidney Failure•
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http://www.youtube.com/watch?v=BodnYcHGtiA
Hemodialysishttp://www.youtube.com/watch?v=shFSW8VE3
Gs ,
http://www.youtube.com/watch?v=TJsVjtsTFBQ
Kidney Transplanthttp://www.youtube.com/watch?v=wBBlJh1vIZc
Kidney Stoneshttp://www.youtube.com/watch?v=mTR35kSDB
so
Common Urinary Terms
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ENURESIS – bedwetting
GLYCOSURIA – sugar in urine
NOCTURIA – frequent urination at night
POLYURIA – large amounts of urine
PYURIA – pus in urine
ANURIA – no urine produced
HEMATURIA – blood in urine
Incontinence- urinating involuntarilyelderly, stroke patients
Urinary Output
• Average = 1500 ml/day
• Kidney’s filter 120 ml (1/2 cup) per
minute
• URINALYSIS – test to check for
glucose, protein, blood and specific
gravity of urine. Abnormal if any of
these is present.
• Normal urine color is pale yellow
• What could make the urine dark amber
colored?
Urinary Disorders…
• CYSTITIS
– Inflammation of the mucous membrane lining
of the urinary bladder
– Most common cause bacteria – E. Coli
– Where does E. Coli live?
– Symptoms – DYSURIA (painful urination) and
frequency
– Usually in females (shorter urethra)
– Rx – antibiotics
Glomerulonephritis
Disease which injures the
glomerulus.
 What will the kidney’s not be
able to do if the glomerulus is
damaged?
• If glomerulonephritis occurs on
its own, it's known as primary
glomerulonephritis.
• If another disease, such as
lupus or diabetes, is the cause,
it's called secondary
glomerulonephritis.
• If severe or prolonged, the
inflammation associated with
glomerulonephritis can
damage your kidneys.
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Causes
Hypertension
Kidney Infections
Lupus
Goodpasture’s Syndrome- rare
immunological lung
disorder- causes bleeding
into the lungs and kidney’s
Glomerulonephritis
Symptoms
• Pink or cola-colored urine from red blood cells in
your urine (hematuria)
• Foamy urine due to excess protein (proteinuria)
• High blood pressure (hypertension)
• Fluid retention (edema) with swelling evident in
your face, hands, feet and abdomen
• Fatigue from anemia or kidney failure
Glomerulonephritis
Treatment
• Anti-hypertensive drugs- hypertension
• Strep or bacterial infection- antibiotics
• Lupus- steroids
• Goodpasture’s Syndrome- Plasmapheresismechanical process that removes antibodies
from your blood by taking some of your plasma
out of your blood and replacing it with other
fluid or donated plasma.
RENAL CALCULI or
NEPHROLITHIASIS
• Made of crystals of calcium phosphate and uric
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acid
Gradually they get larger until they block
ureters and the flow of urine
First symptom – severe pain
Other symptoms – nausea and vomiting,
frequency, chills, fever, hematuria
Diagnosis – by symptoms, ultrasound, or x-ray
Rx – increase fluids to flush out stone,
medications, and if needed – LITHOTRIPSY
LITHOTRIPSY
• Breaks up renal calculi using shock
waves.
• Surgical procedure to remove kidney
stones
• Done on outpatient basis
• If this does not work, a ureoscopy will be
done.
Kidney Failure
• Toxic waste accumulate in the
cells poisoning the them
• An early sign of acute
kidney failure is oliguria.
Causes
• Diabetes- most common
cause
• Damaged Glomeruli
• High Blood Pressure
• Glomerular Diseases
• Inherited and Congenital
Kidney Diseases
• Poison and Trauma
Symptoms
• Changes in urination
• Swelling
• Skin rash/ itching
• Leg, back and side pain
• Metallic taste/ ammonia breath
• Nausea and vomiting
• Feeling cold
• Shortness of breath
• Fatigue
• Dizziness and trouble
concentrating
Test for Kidney Failure
• Blood pressure measurement
• Urine test to measure waste removal
(can be done by a dipstick or more
complete urinalysis)
• Blood test to measure waste removal
Treatment for Kidney Failure
DIALYSIS (HEMODIALYSIS)
– Treatment for kidney failure
– Involves the passage of
blood through device with
semipermeable membrane
– Dialysis serves as substitute
kidney
– Blood from patient flows
through machine and is
filtered
– Can be done at home or in
clinic
– Takes 2-4 hours, 2-3 times a
week
Peritoneal Dialysis
• KIDNEY TRANSPLANT
– As a last resort
– Involves donor organ from
someone with a similar
immune system, tissue match
and same blood type.
– Main complication – rejection
Processing
• Processing Questions- Disorders
• Read the article – Kidney Transplantation
• With the group at your table, read the
Medical Decisions Worksheet. With the
information you have been given in the
article, decide which person should get
the kidney. Be able to support your
decision and share with the class.