A Hot Summer's Night

Renal physiology
1. Kidney Function
  1. Nephrons: the Functional unit of the kidney
    1. A renal corpuscle, a renal tubal, and the associated capillary network, which originates from the cortical radiated arteries
2. Kidney structure
  1. Externally, the kidney is surrounded by fascia, perirenal fat capsule, and the renal capsule. Internally, the kidney is dost importantlyy filled with with nephrons that filters blood and generate urine
3. Urine Formation
  1. Filtration
    1. Blood enters the efferent arteriole and flows into the glomerulus where filterable blood components; such as water, and nitrogenous waste, will move toward the inside of the glomerulus, and non filterable components; such as cells and serum albumins, will exit via afferent arteriole. these filterable components accumulates in the glomerulus to form glomerular filtrate.
  2. Reabsorption
    1. a nephron may either be a passive or active process, and specific permeability of each part of the nephron varies considerably of the amount and type of substances reabsorbed
      1. Acting trasport - membrane - bound ATPase pumps (such as NA+/ K+ ATPase pumps) with carirer protein that substances across the plasma membranes of the kidney epithelial cells by consuming ATP.
      2. Passive diffusion - passing through plasma membranes of the kidney epithelial by concerntration gradient
      3. Contransport - this process is particulary important for the reabsorption of water. water can follow other molecules that are actively transported, particularly glucose and sodium ions in nephrons
  3. Oligouria
    1. < 400 ml/day
  4. anuria
    1. < 100 ml / day
  5. Polyuria
    1. < 2 L / day
  6. Secretion
    1. secretion accuses are similar of those reabsorption, however these process occur in the apposite direction
      1. the substances that are secreted into the tubeuar for removal from the body include
        Ammonium ion (NH4+)
        Hydrogen ion (H+)
        Creatinine
        Urea
        Urea cycle
        Potassium ion (K+)
        Potassium balance
        increased secretion
        diuretic
        Alkalosis
        increase aldosterone
        light potassium potassium
        decreased secretion
        low potassium diet
        decrease aldosterone
        Acidosis
        Potassium sparing diuretics
        intercalated cells help in reabsorption during low potassium diet
        Principal cells secrete during high potassium diet
Shock
1. a life-threatening condition that occurs when the body is not getting enough blood flow
  1. Causes
    1. Heart Problems
    2. Changes in blood vessels
    3. Low blood volume
  2. Types
    1. neurogenic
    2. Sepsis
    3. Hypovolemic
    4. anaphylactic
    5. Cardiogenic
  3. Symptoms
    1. Enlarges pupils
    2. Weakness or fatigue
    3. Nausea or vomiting
    4. Rapid pulse
    5. Dizziness
    6. Rapid breathing
Acute Kidney Failure
1. Chronic Kidney failure
  1. Causes
    1. Diabetes
    2. Hypertension
    3. Policystitis
  2. Caused by acute kidney failure
  3. Manifestations
    1. Chest Pain
    2. Shortness of breath
    3. Sodium & water balance
    4. Metabolic acidosis
    5. Anemia
    6. Potassium balance
Investigations
1. Serum biochemistries
2. Urine analysis with microscope
3. Urine Electrolytes
4. CBC
5. Renal imaging is useful, especially if renal is secondary to obstruction
  1. CT scan: this imaging technique uses contrast dyes to picture the kidney. it may also be used to look for structural abnormalities and the presence of obstruction.
  2. Ultrasound: This test uses sound waves to get a picture of a kidney. it may be used to look for abnormalities in size or position of the kidney or for obstructions such as stones to tumors
Progosis
1. Depends on the causes on the disease
2. Partial recovery of renal function may occur in situation in which the injury does not completely resolve.

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