Page 196 - 84 human physiolofy part-1

Chapter 10

cases, the kidney swells and scars, abscesses form, and the renal pelvis fills with pus. Left untreated,
the infected kidney may be severely damaged, but administration of antibiotics usually achieve a total
cure.

Glomerulonephritis Inflammation of the glomerular can be caused by immunologic
abnormalities, drugs or toxins, vascular disorders, and systemic diseases. Gloerulonephritis can be
acute, chronic or progressive. Two major changes in the urine are distinctive of glomerulonephritis:
hematuria and proteinuria with albumin as the major protein. There is also a decrease in urine as there
is a decrease in GFR (glomerular filtration rate). Renal failure is associated with oliguria (less than 400
ml of urine output per day).

Renal Failure Uremia is a syndrome of renal failure and includes elevated blood urea and
creatinine levels. Acute renal failure can be reversed if diagnosed early. Acute renal failure can be
caused by severe hypotension or severe glomerular disease. Diagnostic tests include BUN and plasma
creatinine level tests. It is considered to be chronic renal failure if the decline of renal function to less
than 25%.

Diabetes Insipidus

This is caused by the deficiency of or decrease of ADH. The person with (DI) has the inability to
concentrate their urine in water restriction, in turn they will void up 3 to 20 liters/day. There are two
forms of (DI), neurogenic, and nephrogenic. In nephrogenic (DI) the kidneys do not respond to ADH.
Usually the nephrogenic (DI) is characterized by the impairment of the urine concentrating capability
of the kidney along with concentration of water. The cause may be a genetic trait, electrolyte disorder,
or side effect of drugs such as, lithium. In the neurogenic (DI), it is usually caused by head injury near
the hypophysisal tract.

Urinary tract infections (UTI's)

The second most common type of bacterial infections seen by health care providers is UTI's. Out
of all the bacterias that colonize and cause urinary tract infections the big gun is Escherichia coli. In the
hospital indwelling catheters and straight catheterizing predispose the opportunity for urinary tract
infections. In females there are three stages in life that predispose urinary tract infections, that is
menarche, manipulation between intercourse, and menopause. However, a small percentage of men and
children will get urinary tract infections. In men it is usually due to the prostate gland growth which
usually occurs in older age men. In children it can occur 3% to 5% in girls and 1% in boys,
uncircumcised boys it is more common than circumcised ones to have a urinary tract infection, in girls
it may be the result of onset of toilet training, some predispositions for getting urinary tract infection
include family history and urinary tract anomalies. In neonates urinary tract infections is most common
when bacteremia is present.

Dialysis and Kidney Transplant

Generally, humans can live normally with just one kidney. Only when the amount of functioning
kidney tissue is greatly diminished will renal failure develop. If renal function is impaired, various

196 | Human Physiology