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An elderly female patient with a history of osteoporosis, chronic type II…

- - - - This occurs when high blood glucose levels damage how a person's kidneys function
        
        This leads to end stage renal disease (ESRD), which is a condition when kidney no longer work well enough to meet the needs of daily life.
        
        ESRD lead to kidney failure with potentially life threatening consequences
- - - - Increased fracture risk
- - - - This could be as a result of glomerulonephritis ( inflammation of filtering system
      - Cystic kidney disease
      - Bladder or kidney stress
      - kidney injury from accident or sport
- - - - The kidneys are the primary organs of the urinary system. The kidneys are the organs that filter the blood, remove the wastes, and excrete the wastes in the urine. They are the organs that perform the functions of the urinary system. The other components are accessory structures to eliminate the urine from the body.
        The paired kidneys are located between the twelfth thoracic and third lumbar vertebrae, one on each side of the vertebral column. The right kidney usually is slightly lower than the left because the liver displaces it downward. The kidneys, protected by the lower ribs, lie in shallow depressions against the posterior abdominal wall and behind the parietal peritoneum. This means they are retroperitoneal. Each kidney is held in place by connective tissue, called renal fascia, and is surrounded by a thick layer of adipose tissue, called perirenal fat, which helps to protect it. A tough, fibrous, connective tissue renal capsule closely envelopes each kidney and provides support for the soft tissue that is inside.
        
        functional anatomy of kidney (Nephron)
        
        Renal corpuscle
        
        Glomerulus
        
        tangle of capillary loops, glomerular capillaries blood entering by afferent arteriole exits by efferent arteriole
        
        Glomerular capsule
        
        This has internal permeable visceral layer, directly overlies glomerular capillaries has external impermeable parietal layer, composed of simple squamous epithelium, capsular space between two layers, receives filtrate, modified to form urine.
        
        Renal tubules
        
        This is the remaining portion of nephron. it consists of three continuous parts
        
        Proximal convoluted tubule (PCT)
        
        first region of renal tubule, originates at tubular pole of renal corpuscle, lined by simple cuboidal epithelium. it has microvilli increasing surface area and reabsorption capacity
        
        Nephron loop
        
        This contains descending limb and ascending limb, connects at a “hairpin turn” within the medulla, lining changes from simple cuboidal epithelium (thick segment) to simple squamous (thin segment) then back to simple cuboidal
        
        Distal convoluted tubule (DCT)
        
        This originates in renal cortex at end of ascending limb, extends to collecting duct, lined by simple cuboidal epithelium without microvilli.
    - - These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls keep tightening and relaxing. This forces urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.
    - - This triangle-shaped, hollow organ is located in the lower belly. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine. They contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to 2 cups of urine for 2 to 5 hours.
    - - This tube allows urine to pass outside the body. The brain signals the bladder muscles to tighten. This squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals happen in the correct order, normal urination happens.
    - - These circular muscles help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder.
    - - The nerves alert a person when it is time to urinate, or empty the bladder.
  - - - This is oriented with renal corpuscles near peripheral cortex, have short nephron loop just penetrating medulla, it is bulk residing within cortex. It contains 85% of nephrons
    - - This is renal corpuscles adjacent to corticomedullary junction, long nephron loops extending deep into medulla, it plays important role in kidneys’ ability produce concentrated urine.
  - - - The Glomerulus Filters Water and Other Substances from the Bloodstream. The glomerulus is a network of capillaries surrounded by a cuplike structure, the glomerular capsule (or Bowman’s capsule). As blood flows through the glomerulus, blood pressure pushes water and solutes from the capillaries into the capsule through a filtration membrane. This glomerular filtration begins the urine formation process.
    - - The glomerulus filters water and small solutes out of the bloodstream. The resulting filtrate contains waste, but also other substances the body needs: essential ions, glucose, amino acids, and smaller proteins. When the filtrate exits the glomerulus, it flows into a duct in the nephron called the renal tubule. As it moves, the needed substances and some water are reabsorbed through the tube wall into adjacent capillaries. This reabsorption of vital nutrients from the filtrate is the second step in urine creation.
    - - The filtrate absorbed in the glomerulus flows through the renal tubule, where nutrients and water are reabsorbed into capillaries. At the same time, waste ions and hydrogen ions pass from the capillaries into the renal tubule. This process is called secretion. The secreted ions combine with the remaining filtrate and become urine. The urine flows out of the nephron tubule into a collecting duct. It passes out of the kidney through the renal pelvis, into the ureter, and down to the bladder.