Urinary & Fluid Disorders

the inferior movement of the kidneys within the abdominal cavity

• due to loss of adipose tissue

• can kink the ureter, blocking flow to the bladder

• if urine backs up, the kidney swells (hydronephrosis)

What is renal ptosis?

• renal agenesis

  • failure of a kidney to develop

• pelvic kidney

  • developing kidney fails to migrate from pelvic cavity

• horseshoe kidney

  • inferior parts of the left and right kidney are fused, both kidneys are joined

• supernumerary kidney

  • extra kidney develops, typically asymptomatic

List 4 types of kidney variations and anomalies

• the excretion of glucose in the urine (not normal)

• classic symptom of diabetes, along with frequent urination and thirst

What is glucosuria?

• measured with an insulin injection (freely filtered substance, not reabsorbed or secreted)

• plasma concentration of insulin is measured at given time intervals, normal GFR is 125 mL/min

How can glomerular filtration rate (GFR) be measured?

a test meant to assess kidney function

• measures the volume of plasma cleared of a specific substance in a given time

What is a renal plasma clearance test?

• when renal function is greatly diminished or absent

• often from a chronic disease affecting the glomerulus or small blood vessels

  • can also be autoimmune, from high bp or diabetes

• two main treatments:

  • dialysis

    • the removal of waste and excess fluid from the blood by machine

  • kidney transplant

What is renal failure?

• kidney stones

• formed from crystalline minerals building up in the kidney

• risk factors:

  • inadequate fluid intake

  • frequent UTIs

  • abnormal chemical or mineral levels in urine

• large stones obstruct the kidney, renal pelvis, or ureter, causes severe pain

What is renal calculi?

• a bacterial or fungal infection of the urinary tract

  • urethra: urethritis

  • bladder: cystitis

  • kidneys: pyelonephritis

• symptoms: painful urination (dysuria), frequent urination, pressure, back pain, nausea

• diagnosed through urinalysis, treated with antibiotics

What are urinary tract infections?

• incontinence

  • inability to voluntarily control urination

  • may occur due to childbirth, strong detrusor muscle contraction, secondary result of medications, or fear

• retention

  • failure to eliminate urine normally

  • can be a side effect of anesthesia or from an enlarged prostate

What are two types of impaired urination?

• an xray of the kidneys, ureters, and urinary bladder

• dye is injected into a vein, which travels through the kidneys and into the urine

• xrays provide a “time lapse” view of urinary flow

What is an intravenous pyelogram?

• excess fluid in the brain

• results in increased pressure within the cranial cavity and compression of vessels

• causes headaches and nausea, and in severe cases, convulsions, coma, or death

• caused by:

  • ischemic stroke

  • brain hemorrhage

  • TBI

  • brain tumor

  • high altitude

What is cerebral edema?

• condition caused by hyposecretion of ADH or the inability of the kidney to respond to ADH

• results in decreased fluid retention and increased urine production

NOT a condition affecting blood sugar levels

What is diabetes insipidus?

lactic acidosis

• acid-base disturbance caused from large amounts of lactic acid

  • when cells are deprived of oxygen, they switch from aerobic respiration to glycolysis, resulting in increased production of lactic acid

• due to prolonged exercise or failure of the CV system

ketoacidosis

• acid-base disturbance due to large amounts of ketoacids

  • ketoacids are produced by cells when they use fat metabolism instead of glucose metabolism for ATP production (because of insufficient glucose uptake)

• those with type 1 diabetes experience this because of inadequate insulin (insulin needed for glucose uptake)

What is the difference between lactic acidosis and ketoacidosis?

tests used to diagnose and monitor acid-base disturbances and compensation

• includes pH, arterial pCO₂ and HCO₃^-

What are arterial blood gases (ABGs)?

• respiratory acidosis is the impaired ability of the respiratory system to eliminate CO₂, blood pCO₂ increases

  • this drives an increase in H₂CO₃ (carbonic acid) in the blood

• the kidneys compensate by increasing secretion of H⁺ and reabsorption of HCO₃^-

What is respiratory acidosis and how do the kidneys compensate?