Lesson 8 Urinary System Diseases and Disorders

Acute Kidney Injury

rapid-onset disease of the kidneys resulting in a failure to produce urine resulting in retention of urea, nitrogen, creatinine and other waste products in the blood.

Acute Poststreptococcal Glomerulonephritis (APSGN)

an immune response made by the kidney after upper respiratory/airway infections (and sometimes skin infections) that causes sudden edema, hematuria, proteinuria and hypertension. Accounts for around 90% of renal disorders in children.

Adult Polycystic kidney

Autosomal dominant gene on chromosome 16
No indications in child and young adults
First manifestations usually around age 40 years
Multiple cysts develop in both kidneys.
Enlargement of kidneys
Compression and destruction of kidney tissue
Chronic renal failure
Diagnosis by abdominal CT scanning or MRI

adrenal glands

a pair of endocrine glands that sit just above the kidneys and secrete hormones (epinephrine and norepinephrine) that help arouse the body in times of stress. They also secrete aldosterone and corticosterone.

aldosterone

"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. Na+ retention promotes water retention, which promotes a higher blood volume and pressure

anemia

A condition in which the blood is deficient in red blood cells or in hemoglobin.

Angiotensin Converting Enzyme (ACE)

converts angiotensin I to angiotensin II (in the lungs)

Angiotensin II

increases blood pressure by:
a) stimulating vasoconstriction, and
b) stimulating the release of aldosterone by the adrenal glands
c) stimulating the release of ADH by the posterior pituitary gland
Aldosterone and Anti-Diuretic Hormone stimulate the kidneys to reabsorb more water and salt which increase blood volume (and therefore blood pressure)

anti-diuretic hormone

A hormone secreted by the pituitary gland that increases water resorption in the nephron, increasing blood volume and therefore blood pressure

azotemia

abnormally high levels of nitrogen (certain substances containing nitrogen, eg. urea, creatinine) in the blood

Benign Prostatic Hypertrophy

noncancerous enlargement of the prostate gland

Blood Urea Nitrogen (BUN)

measurement of urea levels in blood

Bowman's capsule

contains glomeruli. First step in kidney filtration and very high pressure at this point

Chronic Kidney Injury

Gradual irreversible destruction of the kidneys over a long period of time. Asymptomatic in early stages
May result from:
1.Chronic kidney disease (e.g. chronic bilateral pyelonephritis)
2.Congenital polycystic kidney disease (genetic)
3.Systemic disorders (hypertension or diabetes, SLE)
4.Low-level exposure to nephrotoxins over sustained period of time (Drugs, chemicals, or toxins) cause tubule necrosis & obstruction (e.g. scar tissue)

creatinine

nitrogenous waste excreted in the urine

cystitis

inflammation of the bladder

dialysate

the electrolyte solution that circulates through the dialyzer in hemodialysis and through the peritoneal membrane in peritoneal dialysis

enuresis

involuntary urination after the age of 4. Usually occurs in children during sleep.

erythropoietin

A hormone produced and released by the kidney that stimulates the production of red blood cells by the bone marrow.

glomerulus

A ball of capillaries surrounded by Bowman's capsule in the nephron and serving as the site of filtration in the kidney.

hemodialysis

a machine that slowly draws out your blood, then sends it through a dialyzer that works like a kidney to filter out wastes from your blood

hydronephrosis

swelling of kidney from a build up of urine, often due to obstruction or blockage

incontinence

inability to voluntarily control urination

Kidney stone (renal calculi)

can cause tremendous pain in the lower quadrants, radiating in pulse-like waves from the rear flank, downward toward the pubic symphysis worsens as the stone is pushed along. Can cause:
anxiety, restlessness
nausea and or vomiting
hematuria

lithotripsy

Is a treatment for kidneys stones that is not surgery, but uses sound waves to destroy the stones into smaller pieces allowing the stones to pass in the urine.

micturition

expelling urine from the bladder

nephron

functional unit of the kidney

nephrosclerosis

Hardening of the kidney associated with hypertension and disease of the renal arterioles

nephrotic syndrome

type of kidney disease that causes edema and loss of protein from blood into urine because of increased glomerular permeability

neurogenic bladder

impairment of bladder control due to brain or nerve conduction

overflow incontinence

When a bladders muscle weakens and loses its function or there is a blockage, the bladder will become abnormally full. This filling may not cause the person to feel an urge to urinate however there can be an uncontrolled release of urine.

peritoneal dialysis

a form of treatment used during kidney failure involving the peritoneum and a cleansing solution called dialysate. The dialysate absorbs fluid and waste from the blood, while the peritoneum acts as the filter.

pyelonephritis

Inflammation of the kidneys. This is most often caused by a bacterial infection.

renal calculi

solid crystal masses, also known as kidney stones, that form from increased crystal-forming substances (i.e. calcium, uric acid) present in the urine that cannot be diluted.

renin

hormone secreted by the kidney in response to low blood volume. Renin catalyzes the reaction of Angiotensinogen to become Angiotensin I. Angiotensin I is converted to Angtiotensin II by ACE (Angiotensin Converting Enzyme). Angiotensin II raises blood pressure by influencing vasoconstriction (narrowing of blood vessels)

stress incontinence

physical activity that causes pressure on the bladder and results in leakage of urine. More common in women that have had children.

uremia

presence of urinary waste in the blood

uric acid

breakdown product of DNA and RNA; a nitrogenous waste excreted in the urine

urge incontinence

involuntary leakage of urine with a sudden, strong desire to urinate

urinary casts

microscopic cylindrical structures produced by the kidneys. They are present in the urine in certain diseases (and indicate inflammation of glomerulus).

urolithiasis

the forming of hard deposits in the kidney, bladder, or urinary tract. Caused by decreased urine volume or the increase of calcium; phosphate; or oxalate.

vesicoureteral reflux

When the urine flows backwards from the bladder to one or both ureters, or sometimes to the kidneys. This condition is most common in babies and young children.

Wilms' tumor

Is a cancer that occurs in children typically aged 3-4 and effects 1 kidney most often but can also occur in both kidneys, the risk of getting this cancer is greatly diminished after the age of 5. BM

creatinine clearance test

test done to measure the total amount of creatinine excreted in the urine, usually in a 24-hour period, to assess kidney function

hematouria

blood in the urine

glucosuria

glucose in the urine

polyuria

excessive urination

dysuria

painful or difficult urination

proteinuria (albuminuria)

the presence of protein in urine.
The most common blood protein is albumin.
This may be due to diabetes mellitus, renal damage, extreme physical activity, or hypertension. It is a sign of glomerular inflammation.

Specific gravity of urine

measure of the concentration of solutes in the urine

ketonuria

presence of ketones in the urine

bacteriauria

presence of bacteria in the urine

Glomerular Filtration Rate (GFR)

the amount of filtrate formed per minute by the two kidneys combined (90-120ml/min)

cystoscopy

the visual examination of the urinary bladder using a cystoscope

pylogram

x-ray of the kidney

oliguria

Decreased urine output

anuria

absence of urine production

uremic encephalopathy

Altered mental status caused by the accumulation of creatinine and blood urea nitrogen due to renal failure.

uremic frost

urea and uric acid salt deposits excreted in sweat as a result of uremia, giving the skin a powdery appearance