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Understanding the Renal and Urinary System
Sep 30, 2024
Lecture on Renal and Urine System
Objectives
Impact of renal function on blood pressure
Evaluate presentation of CKD, AKI, neurogenic, PCI, and reduction in odor-active blood
Anatomy of the Renal System
Components
: Kidneys, ureters, renal pelvis, bladder
Location
: Kidneys located between 12th thoracic and 3rd lumbar vertebrae
Right kidney slightly lower than left
Nephron: Functional Unit of Kidney
Role
: Concentration and dilution of fluids
Components
:
Renal corpuscle
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting ducts
Types
:
Cortical nephron
Juxtamedullary nephron
Kidney Functions
Glomerulus
:
Afferent arterioles deliver blood
Efferent arterioles carry blood away
Blood filtration and regulation
Peritubular Capillaries
:
Surround renal tubules and aid in reabsorption
Located in cortex and medulla
Renal Blood Flow
Blood Flow Volume
: 1,000 to 1,200 mL/min
Cardiac Output
: 20-25% filtered through kidneys
Glomerular Filtration Rate (GFR)
: Rate of plasma filtration through the glomerulus
Regulation of Blood Pressure and Renal Blood Flow
Auto-Regulation
: Keeps GFR constant despite changes in blood pressure
System pressures between 80-180 mmHg maintain constant GFR
Tubuloglomerular Feedback
: Adjusts blood flow via sodium concentration detection
Hormonal Regulation
Renin
: Responds to low blood pressure, promotes vasoconstriction
Antidiuretic Hormone (ADH)
: Concentrates urine
Aldosterone
: Increases sodium reabsorption, affects blood pressure
Kidney Diseases and Disorders
Urinary Tract Obstruction
Types
: Complete or partial; structural or functional
Effects
:
Dilation and risk of infection
Affects tubular and glomerular function
Can lead to scarring and tubular damage
Nephrolithiasis (Kidney Stones)
Risk Factors
: Age, sex, race, dietary intake, medical history
Types
: Calcium oxalate, phosphate, struvite, uric acid
Urinary Tract Infections (UTI)
Types
: Cystitis, acute pyelonephritis
Common Organism
: E. coli
Symptoms
: Pain, pressure in pelvic region
Acute Kidney Injury (AKI)
Causes
: Hypoperfusion, toxic injury
Classification
:
Pre-renal: Reduced blood flow
Intrarenal: Tubular necrosis
Post-renal: Obstruction
Chronic Kidney Disease (CKD)
Stages
:
Stage 1: GFR > 90, no symptoms
Stage 2: Mild damage, GFR 60-89
Stage 3: Moderate damage, GFR 30-59
Stage 4: Severe damage, GFR 15-29
Stage 5: End-stage renal disease, GFR < 15
Effects
: Affects multiple body systems; cardiovascular, bone metabolism, immune system
Discussion on GFR and Racial Differences
Current practices may still show racial differences in GFR calculations
Recent changes in transplant eligibility criteria to remove racial bias
Summary
Kidney Function
: Urine production, blood pressure regulation, electrolyte balance
Disease Impact
: Can lead to comprehensive systemic effects if not managed properly
Effective early diagnosis and treatment crucial for urinary obstructions and renal diseases
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