Elderly female with history of osteoporosis, chronic type 2 diabetes mellitus, and high blood pressure. Noticed blood in urine. Doctor concerned about effect of BP on kidneys and effects of low kidney function.

Upstream Causes

Downstream Effects

Background Information

Structure of Nephron

Anatomy and Function of urinary system

High Blood Pressure: Can cause arteries around the kidneys to narrow, weaken, or harden

Chronic Type 2 Diabetes Mellitus: High blood sugar levels can damage vessels in the kidneys

DM 2 can cause high blood sugar which can damage vessels in the kidneys

Blood pressure causes the arteries around the kidney to narrow/weaken/harden

Osteoporosis: Causes kidneys to fail in order to maintain calcium levels in the body

Osteoporosis causes kidneys to fail to keep calcium for bones

Lack of blood flow into the kidneys

Plaque and build up can constrict blood flow

Lack of calcium can cause soft and brittle bones

Likely Causes

Bladder Stones

UTI

Kidney Stones

Glomerulonephritis

Can lead to complete renal failure and death

Ureters: Connect the kidneys to the bladder and bring urine to the bladder

Bladder: Muscular sac above and behind the pubic bone and stores urine

Renal Pelvis: The point at where two or three major calyces join together and functions as funnel into the ureter

Urethra: The tube that carries urine from the bladder to the outside of the body

Kidneys: Two bean shaped organs that help filter the blood before it is sent back to the heart

Microscopic structural and functional unit of the kidney that separates water/ions/small molecules from the blood/ filters out wastes and toxins and returns needed molecules to the blood

Osteoporosis: Disease in which the bone density and quality of bone are reduced and occurs slightly and progressively

Blood is filtered through three layers: endothelial cells of capillary wall, a basement membrane, and between the foot processes of podocytes of the lining of the capsule

Proximal Convoluted Tubule: Folded structure connected to Bowman's capsule that promotes selective reabsorption

Distal Convoluted Tubule: Folded structure connected to the Loop of Henle where further selective reabsorption

Proximal Tubule Section: Responsible for the transport of certain molecules out of the blood and into the urine

Hypertension: excessive force on arterial walls and vessel walls. can lead to severe health complications and increase risk of heart disease/stroke/death

Diabetes Mellitus 2: A chronic disease that is characterized by high blood sugar that starts in middle to late adulthood