Kidneys

Homeostasis - Kidneys

• Regulate bone-mineral metabolism

  • Secrete vitamin d for bone health

• Regulate RBC production

• Regulates BP

  • Fluids and sodium

• Influence blood pH

  • H+ ions

• Excrete metabolic waste and water

Kidney Function Labs

BUN, Creatinine, GFR, Specific Gravity (USG)

BUN

Blood test that measures amount of urea nitrogen in blood

• Kidneys filter and remove urea from blood

• 10-20 mg/dL

Creatinine

Creatinine Levels

• Filtered by kidneys and excreted in urine

• 0.5-1.2 mg/dL

GFR

Glomerular Filtration Rate

• Measures how well kidneys are filtering waste products from blood

• >60

Specific Gravity (USG)

Concentration of particles in urine

• Reflects kidney’s ability to dilute urine, higher = dehydration, diarrhea, sweating

• 1.002-1.030

Objective Data

Output, Frequency, Appearance

Output

• At least 30 ml/hour

• Oliguria = < 400 ml/24 hours

• Polyuria = excessive quantity with uncontrolled diabetes

Frequency

• Expected internal no more than 2 hours

• On average 5-6 times/day

• Nocturia = > 2 times/night

Appearance

• Color: Cloudy, pink, orange, amber

• Odor: Fishy = UTI, ammonia = dehydration, fruity = diabetes

Urine Color

Blue, Dark gray, Tea, Pink, Red, Orange, Amber, Yellow, Pale Yellow, Cloudy

Blue

Medication side effect (amitriptyline), foods (asparagus), dye after prostate surgery

Dark gray

Urine contains melanin, melanuria

Tea

Liver disease especially with pale stools, jaundice, myoglobinuria, some meds, food dyes, blood in urine

Pink

With menses, some foods (beets), laxatives, kidney stones, UTI

Red

Blood, cancer, prostate surgery, nephritis, cystitis

Orange

Medication side affect (warfarin), food + dyes, laxatives, dehydration, jaundice

Amber

Gold or concentrated with dehydration, some laxatives, food or supplements with B-complex vitamins

Yellow

Natural yellow = urochrome excretion (pigment from blood), bright neon = vitamins

Pale Yellow

Clear, watery with excess liquids acute viral hepatitis, cirrhosis

Cloudy

UTI, kidney stones

Common Problems

Urge incontinence, stress incontinence, nocturia, hematuria, dysuria

Urge Incontinence

Involuntary loss from overactive detrusor muscle in bladder

Stress Incontinence

Involuntary urine loss with physical strain, sneezing, or coughing

Nocturia

UTs, HF, diuretic medication

Hematuria

UTI, kidney infection, prostate, bladder, or kidney cancer

Dysuria

UTI, acute cystitis, prostatitis, urethritis

Aging Considerations Female

UTI, loss of elasticity and muscle tone, occurs at least 1x per year in 30% females over 85

Aging Considerations Male

Benign prostate hyperplasia (BPH) occurs in 80% of men over 60