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Altered Urinary Function Review structure and function Organs of renal system Kidney Ureter Bladder urethra Kidney

idney Posterior abdominal wall outside peritoneal cavity Nephron functional unit of the !idney Function Filtration Reabsorption "ecretion #ormone production $ongentital disorders #ypospadias %pispadias $ystic disease &ilm's (umor Agenesis and hypoplasia of the !idneys #ypospadias %pispadias Polycystic !idney disease &ilms (umor Bilateral Renal agenesis ) Potters syndrome *aternal Oligohydramios Facial abnormalities Other congenital defects #orseshoe !idney Obstructive +isorders Renal calculi or Nephrolithiasis $alcium o,alate or $alcium phosphate -./012304

"truvate -magnesium5 ammonium5 phosphate4 Uric acid -.04

-6/04

$linical *anifestations of Kidney "tones Pain Flan!5 $7A5 or groin #ematuria 8ntravenous Pyelogram Obstructive disorders Other causes of obstruction (umors5 trauma5 edema5 pregnancy5 BP#5 98 inflammatory processes $onse:uences of obstruction 8nfection #ydronephrosis

Neurogenic bladder Functional obstruction not mechanical 8nterruption of the nerve supply to the bladder *ay be due to $N" or spinal cord dysfunction

Renal (umors Renal adenomas and Renal $ell $ancer $linical *anifestations #ematuria Flan! pain Palpable flan! mass &eight loss

Bladder (umors Ris! factors "mo!ing &or! in chemical5 rubber and te,tile industry &omen who ta!e Phenacetin $linical *anifestations Often asymptomatic #ematuria Urinary fre:uency ; pelvic pain

Urinary tract infections $ysitis Usually bacterial -e1coli4 *ore common in women ")" dysuria< urgency< fre:uency< cloudy5 foul smelling urine -may be asymptomatic4 Pyelonephritis Acute vs= chronic

9lomerular +isorders Acute 9lomerulonephritis #ematuria5 protienuria5 decreased 9FR5 oliguria5 edema5 #A5 #(N &ith t, high rate of full recovery Rapidly progressive glomerulonephritis -RP9N4 9oodpastures syndrome $hronic 9lomerulonephritis

Nephrotic "yndrome %,cretion of >=/ g or more of protein in urine per day +amaged glomerular membranes allow large losses of serum protein %dema5 hyperlipidemia5 lipiduria5 hypoalbuminemia5 proteinuria Acute Renal failure ARF Abrupt reduction of renal function with an accumulation of nitrogenous wastes in blood= $lassifications Prerenal 8nfrarenal Postrenal

$linical *anifestation of ARF (hree phases Oliguria +iuresis Recovery .30 return to full renal function Outcome dependant upon early intervention

$hronic renal failure $hronic and progressive loss of nephrons No symptoms apparent until renal function is less than ?/0 of normal $linical *anifestations Uremia accumulation of to,ins in plasma #ypertension5 anore,ia5 n;v5 diarrhea5 weight loss5 pruritus5 edema5 neurologic changes