Kidney Diseases Definitions: - PowerPoint Presentation

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Kidney Diseases

Definitions:

1-Oliguria

2-Anuria

3-Polyuria

4-Dysuria

5-Hematuria

6-Proteinuria

7-Glycosuria

8-Aminoaciduria

9-sosthenuria

KIDNEY DISEASES

I-Acute renal failure, ARF:

Decr

BF to Kid

A-

Prerenal

: Heart failure, Hemorrhage, Burns, Anaphylactic shock, Sepsis, RA stenosis

B-

Intrarenal

: Acute glomerulonephritis, Acute tubular necrosis (Ischemia or Toxins)

C-

Postrenal

: Bilateral obstruction of ureter, Bladder obstruction, Obstruction of urethra.

Physiologic effect of ARF

1-Retension of , Water, waste products, and electrolytes in the blood and ECF

2-Edema and hypertension

3-Hyperkalemia (K) can be fatal.

4-Metabolic acidosis can be fatal.

5-In severe cases anuria

Artificial kid could be need it.

II- CHRONIC RENAL FAILURE CRF:

Decrease in numbers of functional nephrons 70-75%.

1-DM

2-Hypertension

3-Glomerulonephritis, pyelonephritis, TB

4-Analgesic and heavy metals

5-Urinary tract obstruction : renal calculi, hypertrophy of prostate

6-Congential, Polycystic disease

End stage renal disease

Progressive deterioration of kid function where the dialysis must be used.

Common causes

1-DM 45%

2-Hypertension 27%

3-Glomerulonephritis 8%

4-Polycystic dis 2%

5-Unlown 18%

Effect of CRF

1-Uremia: Increase urea,

creatinine

& uric acid

2-Edema

3-Metabolic acidosis

4-Anemia

5-Osteomalacia, by decrease production of active

vit

D

6-Hypertension, by decrease Na and water excretion

KIDNEY TRANSPLANT

DIALYSIS WITH ARTIFICIAL KIDNEY

MICTURITION:

Fill the bladder progressively – Micturition reflex to empty the bladder.

Anatomy : Bladder body (Detrusor muscle) 40-60 mmHg – Neck (posterior urethra) – Internal sphincter- External sphincter(

volunary

control)

Innervation of bladder

1-Pelvic nerve

A.Sensory

fibers :

Strech

of the bladder

B.Motor

fibers :Parasympathetic to detrusor muscle

2-Pudendal (somatic) fibers to the external sphincter

3-Sympathetic fibers through

hypogastric

nerve mainly to the BV of the bladder and some sensory fibers with it for sensation of fullness and pain

MICTURATION REFLEX

Micturition reflex : Primary stretch receptors-sacral segment by pelvic nerve – back to the bladder through parasympathetic nerve fibers.

Powerful micturition reflex-

pudendal

nerve –external sphincter to inhibit it.

Higher center ( Pons & cerebral cortex) exert final control: Inhibit reflex or prevent micturition by tonic contraction of external sphincter until convenient time.

Micturition reflex

1-Filling phase inhibit parasympathetic activity (Pelvic nerve), bladder & internal sphincter

2- Urination stimulate parasympathetic

3-Sympathetic mainly bladder for BV

4-Pudendal nerve (somatic): for external sphincter

Voluntary urination :

Contraction of abdominal muscle ^ pressure in the bladder –stimulate stretch receptors-excites micturition reflex-inhibit external urethral sphincter -5to10 ml left.

ABNORMAL MICTURATION

1-Destruction of sensory nerve fibers:

(Sacral region & Syphilis)

2-Spinal cord damage above sacral region

3-Lack of inhibitory signals from the brain

4- Incontinence during cough or sneezing in women with many kids or men with prostate surgery (Impaired sphincter)