renal learning objectives

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what is the impact that renal failure has on the rest of the body?
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Terms in this set (23)
what is the impact that renal failure has on the rest of the body?
see book
what are the main malignancies that affect the male and female reproductive system
males- prostate (adenocarcinoma ) increase incidence with age
neuroblastomona
renal cell caricinoma
transitional cell carcinoma
What is glomerulonephritis?
causes of it?
does it affect bilaterally ( 2 of the kidney's or 1)?
inflammation of the glomerulus ( it commonly leads to chronic and renal failure).

causes it's often immune mediated or caused post infection
possible consequences of glomerulonephritis?
These conditions are usually caused by blood-born stimuli and therefore affect both kidney's and predisposing someone to kidney failure
how does glomerulonphritis lead o chronic renal failure?
the damage caused by glomerulonephritis reduces the ability to filter blood properly. waste is therefore collected in the blood stream. also leads to chronic from special cases ( such as infections and autoimune infections)
What is the renal papilla?
Why is the renal papilla susceptible to toxic injury and ascending infections?
the tip of the papilla that projects into the cacalues

the reason why it is susceptible to injury is because it is where the urine is at its's most concentrated
and the reason why it is susceptible to ascending infections is because is the first part of the kidney that the bacteria is going to hit as it goes up from the lower urinary tract
what are the difference between ascending and descending infections?
women are more prone to ascending
descending is carried in the blood

ASCENDING is coming up from the lower urinary system
why are females at a greater risk of UTI INFECIONS
(aute pyelonephritis is a bacterial infection of the pelvis)
Shorter urethra
Urethral opening closer to anus
Lack of prostatic secretions
Increased risk of micro trauma during sex
Changes in mucous viscosity
what are the causes of urinary stones?
super saturated urine
dehydrated urine
infection
what are the consequences of urinary stones?
Haematuria (blood in the urine)
Obstruction leading to hydronephrosis
More stones
pain
increased risk of dysplasia & cancer
how do the kidney's contribute to congestive heart failure?overactivation of RAAS (renin,angiotension 2 aldosterone) angiotensin 2 - causes vasoconstriction leading to vasocontraction of arteries and arterioles. This increases vascular resistance. aldosterone- leads to retention of sodium which increases blood volume and results in systemic hyper tension. systemic hypertension is a factor for atherosclerosis, left heart ventricular hypertrophy and failure also the increase in blood volume increases hydrostatic pressure leading to oedema. decrease in EPO ( erytheropetn) leads to anemia reduce activation of vitamin D. Therefore this decreases the amount of calcium being absorbed in the gut. A calcium isn't being absorbed this will get passed through urine. because of the decrease in calcium his will increase phosphate causing hyperthyroidism. hyperthyroidism leads to Renal osteodystrophy and soft tissue calcification. acidosis- which leads to hyperkalemia and cardiac arrhythmia's there will also be a waste in the blood leading to nausea / tirednesswhat are some of the common systematic manifestations of renal failure?are ascending or descending urinary tract infections more prone to renal failure?Ascending infections are from the lower urinary tract & may only damage one kidney or part of one kidney. The pain experienced induces the patient to seek treatment which will be aggressive to restore health Descending infections as it is more likely to affect both kidneys; descending infections are more serious as they are blood born so will lead to damage of both kidneys & potentially all nephrons and thus can cause renal failure. An infection in the blood can also lead to meningitis, encephalitis & osteomyelitis all of which we will cover in future weeks.1.Who is likely to be the youngest patient at diagnosis?Patient A has renal cell carcinoma Patient B has nephroblastoma Patient C has transitional cell carcinomadefine Glomerulonephritisinflammation of the glomerulusWhat is the likelihood of being a carrier of adult polycystic kidney disease if one of your parents has the disease?Adult polycystic kidney disease is an autosomal dominant disorder so if you inherit one diseased allele you have the disease so there is no carrier status.What has happened to the normal renal parenchyma in response to the formation and growth of the cysts?As the cysts form and expand they cause tissue atrophy, the parenchymal cells of the kidney die by apoptosis leaving just the cysts.what does the term blast stand for?was never a normal cell to begin wit hPapillary carcinoma of the ureter with kidney showing hydronephrosis & Papillary Bladder carcinoma are named papillary as they are growing in a papillary structure, what would be the appropriate name based on their cell of origin?Transitional cell carcinomawhy is it that nephroblastoma's, primary renal cell carcinomas and papillary carcinoma's are not the same?The cell of origin differs in these cancers. In the case of nephroblastomas, the original cell is unknown but suspected to be a foetal cell. ( common in young kids)Why are cancers of the kidney, ureter and bladder generally diagnosed late, what signs and symptoms do patients present with?Patients with urinary cancers often present with blood in the urine, mild flank pain, an abdominal mass or obstruction late in the progression of the disease, the early stages are asymptomatic.Routes of entry for microbes infecting the kidney include haematogenous (descending) and urinary (ascending) spread, what are the most significant differences between these?Descending infections are likely to affect both kidneys and so lead to renal failure. Ascending infections are more likely to affect 1 kidney and usually only a segment of that kidney.risk of atherosclerosisdiabetes, being male, age, systemic hypertension, hyperlipidemia.