Chapter 39: Alterations of Renal and Urinary Tract Function

Vocabulary flashcards covering renal and urinary tract alterations including obstructions, infections, glomerular disorders, and kidney injury types.

Hydroureter

The accumulation of urine in the ureter caused by an obstruction.

Hydronephrosis

Dilation of the renal pelvis and calyces proximal to a urinary tract obstruction.

Compensatory hypertrophy

A process where the unaffected kidney increases in size by $5-12\%$ to compensate for renal damage, occurring under the influence of yet unidentified hormones.

Postobstructive diuresis

The rapid excretion of large volumes of water and electrolytes (up to $10\,L/day$) following the relief of a bilateral partial obstruction.

Renal calculi

Also known as kidney stones, these are urinary stones that are most commonly unilateral.

Supersaturation

A state in which urine contains a higher concentration of a salt than the volume of urine is able to dissolve, leading to crystal formation.

Detrusor hyperreflexia

Reflex urinary incontinence caused by lesions above C2 where the bladder empties automatically when full; associated with stroke, TBI, or MS.

Detrusor areflexia

A lower motor neuron lesion occurring below S1 involving the sacral micturition center, resulting in a bladder that will not contract and causes urine retention.

Overactive bladder syndrome (OAB)

A chronic syndrome of detrusor overactivity characterized by urgency, frequency, and nocturia in the absence of infection.

Cystocele

A downward protrusion of the bladder into the vagina, often occurring among women with pelvic organ prolapse.

Cystitis

An inflammation of the bladder, which is the most common site for a symptomatic UTI.

Pyelonephritis

An infection of one or both upper urinary tracts, commonly caused by E. coli, Proteus, or Pseudomonas.

Glomerulonephritis

Inflammation of the glomerulus caused by primary injury (ischemia, drugs, toxins) or secondary injury due to systemic diseases like DM or lupus.

Nephrotic syndrome

The excretion of $3.5\,g$ or more of protein in the urine per day due to glomerular injury, resulting in hypoalbuminemia and edema.

Nephritic syndrome

A condition characterized by hematuria, red blood cell casts in the urine, and less severe proteinuria than nephrotic syndrome.

Azotemia

Increased serum urea levels and frequently increased creatinine levels indicating an accumulation of nitrogenous waste.

Uremia

A proinflammatory state associated with the accumulation of urea and other nitrogenous compounds, representing the systemic symptoms of renal failure.

Acute Kidney Injury (AKI)

A sudden decline in kidney function with a decrease in glomerular filtration and an increase in serum creatinine and BUN.

Prerenal AKI

The most common form of AKI, caused by inadequate kidney perfusion or hypoperfusion.

Intrarenal AKI

Kidney injury caused by direct damage to the renal parenchyma, commonly due to acute tubular necrosis.

Postrenal AKI

Acute kidney injury resulting from bilateral obstruction to urine flow, which increases intraluminal pressure.

Chronic Kidney Disease (CKD)

The progressive loss of renal function associated with systemic diseases like HTN and diabetes, classified into stages based on GFR levels.

End-stage kidney disease (ESKD)

The final stage of chronic kidney disease where the GFR is less than $15\,mL/min$.