Professional Documents
Culture Documents
Gary L. Schofield, RN
Obstruction
Renal Cancer
Glomerulonephritis
UTI
Pylenephritis
Renal Failure
Acute
-Reverses - Abrupt renal functions
Chronic
Progressive/ Irreversible
Complete Renal Failure GFR gradually Intra renal Acute tubular necrosis Acute glomerulonephritis Renal Vascular Obstruction Cortical Necrosis Allograft Rejection Transplant
Nephrons destroyed
Dialysis
Bladder = infection
Renal
Tumors
Bladder
Obstruction
Bladder = Acute or Chronic Renal Failure
Wilms Tumor
Hydroureter Hydronephrosis
Embryonal Tumor Nephroblastoma Sporadic and inherited origins Associated with other anomalies
Urethral Stricture
Gender Race Geographic Location Seasonal Factors Fluid Intake Diet Occupation
Congenitally abnormal ureter Reflux of urine from bladder to kidney Infection, renal scarring, pyelonephritis
Vesicoureteral Reflux
UTI
Pyleonephritis
Cystitis
Virulence of Uropathogens
Most Common Site for UTI
Acute
Tumors
Association: Tobacco Use, Obesity, Long-term Analgesic use
Common Causes: Kidney Stones Vesicoureteral Reflux Pregnancy Neurogenic Bladder Instrumentation Female Sexual Trauma
Secondary
Increase Risk
Smokers (men)
Pyelonephritis
Acute
Common Cause: E Coli
Chronic
Common Causes Kidney Stones Vesicoureteral Reflux Pregnancy Neurogenic Bladder Instrumentation Female Sexual Trauma
Usually localized abscesses Healing occurs Deposition of Scar tissue Atrophy of affected tubules
Affects primarily the pelvis, calyces, and medulla Rarely causes renal failure
Renal Failure
Glomerular Disorders
Glomerulonephritis
Acute Glomerulonephritis S/S Hematuria Red Blood Cell Casts Protenuria GFR Oliguria Edema HTN Abrupt onset 7-10 after infection Group A Strep S/S 10-21days after infections
Nephrotic Syndrome
Most Common Form Most individuals Children recover with minimal loss of renal function Disturbance in Glomerular Basement Memb (metabolic, biochemical, physiochemical) leads to increase permeability to protein
Chronic Glomerulonephritis
Antiglomerular Basement Membrane (Good-pasture Syndrome) Prognosis variable 20-50% progress to Renal Fail
Hypoalbuminema
Hyperlipidemia
Proteinuria
Lipiduria
Tubular dilation and atrophy Cause: Immune response Toxin/Drugs Vasc. Disorders Damage: Biochemical Mediators of Inflammation Complement activation Neutrophils/Monocytes Poor Prognosis
Hypocalcemia
Poor Prognosis
Treatment: Normal, Low-fat Diet; Salt Restriction Diuretics; Antigoagulants; Removal of toxins; Steroids; Albumin Replacements
Renal Failure
Definition
Congenital condition in which the urethral meatus is located on the ventral side of the penis
Facts
Related to disruption in male hormones Accompanied by Chordee or penile torsion Corrective Surgery
Urethral opening small and situated behind the glans with fissure extending the length of penis Constant dribbling of urine Caused by intrauterine failure of the abdominal wall and the mesoderm of the anterior bladder to fuse Reconstructive surgery girls teens Boys 2-3 yrs of age Intrinsic malformation of smooth muscle or urothelial development produces obstruction in 90% of cases. Causes kinking and scarring Polyps rarely arise form the prostatic urethra often cause sever obstruction and impair renal embrogenesis leading to UTI, Vesicoureteric reflux, and renal failure. Resection as soon as possible Associated with a functional or organic obstruction of the collecting system Obstruction may begin prior to birth
Extensive congenital anomaly in which the lower urinary tract is exposed directly to the surface of the body
Ureteropelvic Junction Obstruction Bladder Outlet Obstruction Hypoplastic(Dysplastic Kidneys Renal Agenesis Polycystic Kidneys
Blockage of the tapered point where the renal pelvis transitions into the ureter
A urethral valve is a thin membrane of tissue that occludes the urethral lumen and obstructs urinary outflow in males.
Ureteric duct grows into the metanephric tissue, triggering the formation of the kidneys in utero. If this growth does not occur the kidney is absent or hypoplastic (small) Renal dysplasia results from abnormal differentiation of renal tissue Absence of one or both kidneys Potter syndrome (bilateral renal agenesis) Autosomal dominant inherited disorder PKD-1 and PKD-2 mutations account for the disease
Clearly hereditary Bilateral agenesis is usually fatal Unilateral males more affected The gene products regulate epithelial growth and differentiation.
References
Corwin, E. J. (2000). Handbook of Pathophysiology (2nd ed.). Philadelphia, PA: Lippincott. Gray, M., Huether, S., & Forshee, B. (2006). Alterations of renal and urinary tract function. In K. L. McCance & S. Huether (Eds.), Pathophysiology: The Biologic Basis for Disease in Adults & Children (pp.1301- 1336). St Louis, MO: ElSevier Mosby. Huether, S. (2006) Alteration of renal and urinary tract functions in children. In K. L. McCance & S. Huether (Eds.), Pathophysiology: The Biologic Basis for Disease in Adults & Children (pp.1337- 1351). St Louis, MO: ElSevier Mosby.