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Female patient had history or osteoporosis, chronic DM II, high BP.…
Female patient had history or osteoporosis, chronic DM II, high BP. Noticed blood in urine
GENERAL FUNCTIONS:
Elimination of metabolic wastes
Regulation of ion levels
Regulation of acid-base balance
Regulation of blood pressure
Elimination of biologically active molecules
Formation of calcitriol
Production and release of erythropoietin
Potential to engage in gluconeogenesis.
filter blood and convert the filtrate into urine
GENERAL ANATOMY
2 Kidneys
renal cortex
renal medulla
ureters
urinary bladder
urethra
NEPHRON (cortical nephron 85% and juxtamedullary nephron 15%)
renal corpuscle
glomerulus (glomerular capillaries)
blood enters through afferent arteriole
blood exits efferent arteriole
glomerular capsule (bowman's capsule)
internal permeable visceral layer
external impermeable parietal layer
capsular space that receives the filtrate which is then modified to form urine
renal tubule
proximal convoluted tubule
nephron loop (loop of Henle)-- descending and ascending limb
distal convoluted tubule
collecting tubule and collecting duct
juxtaglomerular apparatus
granular cells
macula densa cells
FILTRATION
The movement of substances from the blood within the glomerulus into the capsular space
water, glucose, amino acids, ions, urea, hormones, vitamins B and C, ketones (exchange of gases, nutrients and waste)
glomerular capillaries
REABSORBTION
The movement of substances from the tubular fluid back into the blood
urea, water, potassium, sodium, chloride, glucose, amino acids, lactate, phosphate, and bicarbonate
PCT
SECRETION
The movement of substances from the blood into the tubular fluid
potassium ions, hydrogen ions
PCT
OSTEOPOROSIS
density and quality of bone are reduced
risk of fracture significantly increases
more likely to occur in women than in men
low estrogen/ testosterone levels
low intake os calcium and vitamin D makes you more prone (malnutrition)
treatment includes therapeutic medications, intake of calcium and vitamin D and exercise
DM II
decreased insulin or decreased insulin effectiveness
Obesity, treated with diet, exercise, medication to enhance insulin release or insulin sensitivity
high blood pressure and frequent urination
HYPERTENSION
abnormally high blood pressure
causes include obesity, smoking, lack of physical activity, too much salt and alcohol consumption
increases risk of heart disease and stroke
treatment includes reduction of stress, increase physical activity, and lifestyle adjustments
hypertension
uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden
When the blood vessels become damaged, the nephrons that filter your blood don’t receive the oxygen and nutrients they need to function well
damaged arteries are not able to deliver enough blood to the kidney tissue
kidneys lose their ability to filter blood and regulate the fluid, hormones, acids and salts in the body.
damaged kidneys cannot produce aldosterone to regulate blood pressure
high blood pressure can cause damage to blood vessels and filters in the kidney (kills nephrons), making removal of waster difficult
vessels can become narrow and clogged
large amounts of proteins (albumin) will pass through and excreted in urine
DM II (high blood glucose) can cause damage to blood vessel filtering units in the kidneys (damages tissues)
Diabetes also cause damage to nerves in the body. This can cause difficulty in emptying bladder. The pressure resulting from your full bladder can back up and injure the kidneys
DM2
body will retain more water and salt than it should, which can result in weight gain and ankle swelling
waste build up in blood
protein in urine
frequent urination
nausea/ vomitting
weakness/ anemia
osteoporosis
hormonal imbalance of kidneys
osteoporosis causes damaged kidneys lead to abnormal amounts of hormone secretion
causes calcium levels to be out of balance
kidney fails to secrete calcitrol
women who hit menopause
all three conditions are seen in postmenopausal women
hematuria (blood in urine) caused by disease or inflamed kidneys
kidneys do not function properly causing an accumulation of toxins
urinary infection
RBC/ WBC/albumin can get through
infections or bacterial colonies can live in membrane and WBC become lodged in kidney nephron
no treatment can lead to severe pain, discomfort and even cancer
osteoporosis: serious bone fractures, disabilities, chronic pain, death
DM II: kidney damage, blindness, heart failure, stroke, amputation, nerve damage, death
high blood pressure: heart attack, blood clots, stroke, kidney failure, blindness, atherosclerosis