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KIDNEY DISEASES I-Acute renal failure, ARF: Decr BF to Kid

Kidney Diseases Definitions: 1-Oliguria 2-Anuria 3-Polyuria 4-Dysuria 5-Hematuria 6-Proteinuria 7-Glycosuria 8-Aminoaciduria 9-sosthenuria. KIDNEY DISEASES I-Acute renal failure, ARF: Decr BF to Kid A- Prerenal : Heart failure, Hemorrhage, Burns, Anaphylactic shock, Sepsis, RA stenosis

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KIDNEY DISEASES I-Acute renal failure, ARF: Decr BF to Kid

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  1. Kidney DiseasesDefinitions:1-Oliguria2-Anuria3-Polyuria4-Dysuria5-Hematuria6-Proteinuria7-Glycosuria8-Aminoaciduria 9-sosthenuria

  2. KIDNEY DISEASES • I-Acute renal failure, ARF: Decr BF to Kid • A-Prerenal : Heart failure, Hemorrhage, Burns, Anaphylactic shock, Sepsis, RA stenosis • B-Intrarenal : Acute glomerulonephritis, Acute tubular necrosis (Ischemia or Toxins) • C-Postrenal : Bilateral obstruction of ureter, Bladder obstruction, Obstruction of urethra.

  3. Physiologic effect of ARF • 1-Retension of , Water, waste products, and electrolytes in the blood and ECF • 2-Edema and hypertension • 3-Hyperkalemia (K) can be fatal. • 4-Metabolic acidosis can be fatal. • 5-In severe cases anuria • Artificial kid could be need it.

  4. II- CHRONIC RENAL FAILURE CRF: Decrease in numbers of functional nephrons 70-75%. • 1-DM • 2-Hypertension • 3-Glomerulonephritis, pyelonephritis, TB • 4-Analgesic and heavy metals • 5-Urinary tract obstruction : renal calculi, hypertrophy of prostate 6-Congential, Polycystic disease

  5. End stage renal diseaseProgressive deterioration of kid function where the dialysis must be used.Common causes1-DM 45%2-Hypertension 27%3-Glomerulonephritis 8%4-Polycystic dis 2%5-Unlown 18%

  6. Effect of CRF • 1-Uremia: Increase urea, creatinine & uric acid • 2-Edema • 3-Metabolic acidosis • 4-Anemia • 5-Osteomalacia, by decrease production of active vit D • 6-Hypertension, by decrease Na and water excretion

  7. KIDNEY TRANSPLANT DIALYSIS WITH ARTIFICIAL KIDNEY

  8. MICTURITION: • Fill the bladder progressively – Micturition reflex to empty the bladder. • Anatomy : Bladder body (Detrusor muscle) 40-60 mmHg – Neck (posterior urethra) – Internal sphincter- External sphincter(volunary control)

  9. Innervation of bladder1-Pelvic nerve A.Sensory fibers :Strech of the bladderB.Motor fibers :Parasympathetic to detrusor muscle2-Pudendal (somatic) fibers to the external sphincter3-Sympathetic fibers through hypogastric nerve mainly to the BV of the bladder and some sensory fibers with it for sensation of fullness and pain

  10. MICTURATION REFLEX • Micturition reflex : Primary stretch receptors-sacral segment by pelvic nerve – back to the bladder through parasympathetic nerve fibers. • Powerful micturition reflex- pudendal nerve –external sphincter to inhibit it. • Higher center ( Pons & cerebral cortex) exert final control: Inhibit reflex or prevent micturition by tonic contraction of external sphincter until convenient time.

  11. Micturition reflex1-Filling phase inhibit parasympathetic activity (Pelvic nerve), bladder & internal sphincter 2- Urination stimulate parasympathetic3-Sympathetic mainly bladder for BV4-Pudendal nerve (somatic): for external sphincter

  12. Voluntary urination : Contraction of abdominal muscle ^ pressure in the bladder –stimulate stretch receptors-excites micturition reflex-inhibit external urethral sphincter -5to10 ml left.

  13. ABNORMAL MICTURATION1-Destruction of sensory nerve fibers:(Sacral region & Syphilis)2-Spinal cord damage above sacral region3-Lack of inhibitory signals from the brain4- Incontinence during cough or sneezing in women with many kids or men with prostate surgery (Impaired sphincter)

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