Urinary Conditions

Locations of Urinary conditions

Upper - Kidneys & Ureters

Lower - Bladder & Urethra

Upper UTI’s are potentially more serious than lower because of risk of kidney damage

AUR Acute Urinary Retention

Inability to empty bladder

MEDICAL EMERGENCY

AUR Causes

Prostate enlargement - benign prostate hyperplasia

Urethral stricture - inflammation/scar tissue

Urinary tract stones - blocks opening to urethra

Nerve problems - vaginal childbirth, spinal cord/pelvic injury/trauma

Aging - inability to empty bladder completely

AUR S&S

Severe lower abdominal pain

Unable to pass urine

Reduced flow

Signs of infection

Swelling of bladder

Without prompt treatment may pass back up to kidneys which may damage them

UTI - Urinary Tract Infections

When part of the tract becomes infected usual bacterial

Mainly occur in women as urethra shorter

UTI - Underlying causes in men

Narrowing of urethra (stricture)

Stricture - like a kink in a straw

Previous STI

Bladder stones

Prostate problems

UTI - Symptoms

Pain/burning when urinating

Cramping in lower abdomen or back

Dysuria - painful/burning difficulty urinating

Increased frequency of urination

Confusion n the elderly

Strong smelling urine

Haematuria - cloudy urine or frank (bright) blood

? Kidney infection temperature >38, rigors (shivering), vomiting

Nausea and vomiting

Kidney Stones - Renal Calculi

Small stone like lumps that can develop in one or both kidneys

Stone moves through ureters and stretches the wall

Often with nausea and vomiting

Small stones may pass painlessly

Common for a stone to block part of the urinary system

Renal Calculi S&S

Persistent ache lower back/groin/side of abdomen

Periods of intense pain on back/side of abdomen - renal colic

Feeling restless

Frequent urination

Nausea/vomiting

Pain when urinating

Blood in urine

Can lead to UTI

AKI - Acute Kidney Injury

Sudden episode of kidney damage or failure happens within few hours or days

Can range from minor loss of function to complete failure

Causes a build up of waste products in the blood making it hard for kidneys to maintain fluid balance

Essential it is treated promptly without quick treatment abnormal levels of salts and chemicals build up which may affect the ability of other organs to work properly

If kidneys shut down may require dialysis or lead to death

Most cases of AKI are caused by reduced blood flow to kidneys

Less than 100ml urine passed in 24hrs always ?AKI

AKI S&S

Nausea/vomiting

Less than 100ml urine in 24 hours

Diarrhoea

Dehydration

High BP

Confusion

Drowsiness

Abdominal pain/back ache

AKI - Causes

Reduced blood flow to kidneys can be caused by:

Low blood volume

Heart pumping less blood than usual

Problems with blood vessels

Certain medication

Can also be caused by a problem with the kidney itself or a blockage affecting drainage

Enlarged prostate

Tumour in pelvis/ovaries/bladder

Kidney stones

AKI - treatment and complications

Treatment:

Increased fluid intake

Antibiotcs

Stopping certain medications

Catheter for drainage

Complications:

High potassium in blood can cause muscle weakness

Pulmonary Oedema (fluid in lungs)

Metabolic Acedosis (Acidic Blood) which can cause nausea, vomiting, drowsiness and breathlessness

CKD - Chronic Renal Failure/Chronic Kidney Disease

Common condition often associated with aging

Usually no symptoms in early stages

Usually caused by other conditions putting strain on kidneys including:

High BP

Diabetes

High cholesterol

Kidney infections

Glomerulonephritis (inflammation of glomeruli small blood vessels beginning of nephron of kidney)

Polycystic kidney disease

Blockages in urine flow

Lorn term use of some medication

Can become serious leading to kidney failure

Most people can control with medication

People with CKD have increased risk of other problems such as cardiovascular disease

CKD S&S

Tiredness

Swollen ankles or feet

Shortness of breath

Feeling sick

Blood in urine

Nausea/vomiting

Hypertension

CKD - Treatment and Management

Treatment:

Lifestyle changes

Medication

Dialysis

Kidney transplant

Management:

Oxygen

Pain relief

Constant Obs

Consider Sepsis

12 lead if elderly/cardiac risk factors/abdominal pain

Transfer to further care

Kidneys and regulating blood pressure

Kidneys release a key hormone called Renin when they sense low blood pressure which triggers a chemical chain reaction to narrow blood vessels and retain salt and water