Renal & Urologic System

Upper urinary tract

Includes the kidney and ureters.

Lower urinary tract

Includes the bladder and urethra.

Nephrons

Filtering units of the kidneys that filter waste products and remove excess fluid from the blood.

Glomerulus

Filters the blood, and the tubule returns needed substances back to the blood while secreting waste.

Renin angiotensin aldosterone system

Influences peripheral vascular resistance and regulates blood pressure, water, and electrolyte balance.

Proximal tubule

Reabsorbs ions, water, amino acids, urea, and glucose.

Loop of Henle

Reabsorbs water and ions.

Distal tubule

Absorbs more ions, bicarbonate, and water.

Collecting duct

Reabsorbs sodium, chloride, bicarbonate, water, and urea.

Peritubular capillaries

Surround the tubules and help with reabsorption of materials from the tubule as well as secretion.

Renal calculi (Kidney stones)

Solid pieces of material that form in the kidney from substances in the urine.

Chronic kidney disease

Impairment of glomerular filtration resulting in renal insufficiency or failure.

NSAIDs

Nonsteroidal anti-inflammatory drugs that can cause kidney damage and contribute to chronic kidney disease.

Dialysis

Renal replacement therapy that replaces the kidneys' excretory function through a semi-permeable membrane to filter out toxic waste substances from the blood.

Peritoneal dialysis

Introduction of dialysis fluid into the peritoneal cavity via a catheter to filter waste products and extra fluids from the vascular system.

Kidney transplant

Best treatment for end-stage renal disease in young patients, offering the opportunity for normal renal function and improved lifestyle.

Exercise and chronic kidney disease failure

Patients with chronic kidney disease experience impaired exercise tolerance and reduced muscle strength/endurance, which worsens as the disease progresses.

Skeletal muscle fatigue

Chronic kidney disease patients exhibit skeletal muscle atrophy and weakness, often accompanied by neuropathy and reduced flexibility and coordination.

Resistance training

Recommended exercise for dialysis patients to improve muscle strength, muscle mass, functional performance, and quality of life.

Clinical implications for physical therapy

Resistance training in dialysis patients can also reduce inflammation, maintain body weight, increase protein utilization, nitrogen retention, and enhance cardiovascular tone at rest.

Glomerular Disease

A condition where the kidneys are unable to filter toxins properly, resulting in the excretion of red blood cells and proteins in the urine.

Nephritis and nephrotic syndrome

Glomerular disease characterized by elevated blood pressure, fluid retention, fatigue, and a decrease in urine production.

Key feature of Glomerular Nephritis

Presence of blood in the urine (hematuria), which may go unnoticed until routine urine analysis.

Key features of glomerular nephrotic

Presence of protein in the urine (proteinuria), no blood in the urine, and worsening kidney function as the syndrome progresses.

Disorders of the bladder and urethra

Bladder cancer, a complex process involving muscle coordination, nerves, signals, hormones, and regulated by the brain and spinal cord.

Urinary inconsistency

Complaint of involuntary urine loss, categorized as stress urinary incontinence (effort or physical exertion) or urgency urinary incontinence (associated with sudden compelling desire to urinate).

Bladder diary

A tool to determine the frequency, timing, and amount of urinary incontinence.

Neurogenic Bladder Disorder

Bladder dysfunction caused by neurological conditions such as Parkinson's disease, multiple sclerosis, spinal cord injury, diabetes, and dementia.

PT's role in neurogenic bladder disorder

Assessment and treatment of bladder and bowel functions, functional mobility, and prevention of complications like urinary tract infections and renal damage.

Interstitial Cystitis (ICC)/Painful Bladder Syndrome (BPS)

Long-term bladder pain, discomfort, pressure, urgency to pass urine, and lower urinary tract symptoms lasting for six weeks or more without infection or clear cause. Often associated with irritable bowel syndrome or fibromyalgia.