Detoxification

Definition of Detoxification

The removal of toxic substances from the human organism to promote homeostasis

What are the attributes of detoxification?

• Hepatic

• Renal

Detox relies on both the _______ and the _______ to help promote and eliminate wastes

Kidneys; liver

What is the pathway of ammonia becoming waste?

Ammonia → To liver → Converted to Urea → To kidneys for removal

What accumulates when the liver does not work properly?

Ammonia accumulates (not converted to Urea)

What accumulates when the kidneys do not work properly?

Urea and Creatinine accumulate (not eliminated from the body)

What are the lifespan considerations for Infants/Toddlers/Children?

• Immature systems

  • May see jaundice at birth

• Lack of elimination control

  • After control develops, can develop constipation d/t refusing “to go”

• Child dosing of medications

  • Some medications are avoided

What are the lifespan considerations for Pregnancy?

• Risk of UTI

• Constipation, potential loss of control after birth

• Urinary frequency, urinary retention after childbirth, changes in control

What are the lifespan considerations for Older Adults?

• Organ function begins to decline at ~40 years

• Increased risk of issues with medications (nephrotoxicity and hepatotoxicity)

• Urinary retention

• Weakened pelvic floor

• Enlarged prostate

What are some diseases of the liver or the kidneys?

• Cirrhosis (Liver)

• Hepatitis (Liver)

• Chronic Kidney Disease

  • Diffuse, bilateral disease of the kidneys with progressive destruction and scarring of nephron

• Chronic scarring (Kidney and Liver)

• Fibrosis (Liver)

What are some chronic conditions which damage the liver/kidneys?

• Hypertension and atherosclerosis impact perfusion to and from kidneys → Heart failure, diabetes (number one cause) (Renal)

• Medications (nephrotoxic/hepatotoxic)

• Chronic alcohol use, too much fat collecting in liver (obesity, diabetes, hyperlipidemia, bile duct disorders (Hepatic))

What is atherosclerosis?

The buildup of fats, cholesterol, and other substances in and on the artery walls.

What is the buildup caused by atherosclerosis called?

Plaque

Ammonia is generally more ______ to the brain than _______.

toxic; urea

What is Hepatic Encephalopathy?

The loss of brain function when a damaged liver doesn’t remove toxins from the blood.

How does ammonia relate to Hepatic Encephalopathy?

Ammonia easily crosses the blood-brain barrier, and can cause neuron dysfunction (Hepatic Encephalopathy).

What are the symptoms of ammonia toxicity?

• Asterixis (muscles relax briefly while using them, may be flapping or tremor like movements)

• Changes in personality

• Agitation

• Restlessness

• Impaired judgement

• Slurred speech

• Incoherence

• Confusion

• Disorientation

What is Uremia?

A buildup of waste products in your blood that occurs as a result of untreated kidney failure

What are the signs of Uremia?

• Nausea

• Apathy

• Weakness

• Fatigue

• Mental status changes

• Decline in cell/organ function

What does a high ammonia test signify?

Dysfunctional Liver

What does a high urea/creatinine test signify?

Dysfunctional Kidney

What are some functions of the liver?

• Medication Breakdown

• Metabolism of foods

• Production of clotting factors

• Storage of Vitamin K

• Bile secretion

How does the liver breakdown meds?

• Makes meds less toxic

  • In liver dysfunction, liver is more sensitive to drugs

How does the liver metabolize food?

Nutrient-rich blood enters. The liver metabolizes:

• Glucose (stored as glycogen) - if unable to store, then sits in the bloodstream → hyperglycemia

• Coverts glycogen to glucose → hypoglycemia