This document provides an overview of renal and urinary tract function and dysfunctions. It includes concept maps showing the potential causes and processes involved in renal failure, as well as common causes of acute and chronic renal failure. Various renal and urinary tract disorders are described such as glomerulonephritis, pyelonephritis, kidney stones, tumors of the kidney and bladder, and congenital abnormalities of the urinary tract.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
This document provides an overview of renal and urinary tract function and dysfunctions. It includes concept maps showing the potential causes and processes involved in renal failure, as well as common causes of acute and chronic renal failure. Various renal and urinary tract disorders are described such as glomerulonephritis, pyelonephritis, kidney stones, tumors of the kidney and bladder, and congenital abnormalities of the urinary tract.
This document provides an overview of renal and urinary tract function and dysfunctions. It includes concept maps showing the potential causes and processes involved in renal failure, as well as common causes of acute and chronic renal failure. Various renal and urinary tract disorders are described such as glomerulonephritis, pyelonephritis, kidney stones, tumors of the kidney and bladder, and congenital abnormalities of the urinary tract.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
This document provides an overview of renal and urinary tract function and dysfunctions. It includes concept maps showing the potential causes and processes involved in renal failure, as well as common causes of acute and chronic renal failure. Various renal and urinary tract disorders are described such as glomerulonephritis, pyelonephritis, kidney stones, tumors of the kidney and bladder, and congenital abnormalities of the urinary tract.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
Download as ppt, pdf, or txt
You are on page 1of 8
Alterations of Renal and Urinary
Tract Function Concept Maps
Gary L. Schofield, RN !otential Causes & !rocess of Renal Failure Renal Failure Obstruction UT Renal Cancer !ylenephritis Glomerulonephritis Acute Chronic End Stage Renal Disease -Reverses - Abrupt | renal functions mpaired Renal Blood Flow Pre renaI (Renal schemia) Shock | CO Anaphylaxis Intra renaI Acute tubular necrosis Acute glomerulonephritis Renal Vascular Obstruction Cortical Necrosis Allograft Rejection Post renaI Kidney Stones Neoplastic Disease !rogressive/ rreversible GFR gradually | Nephrons destroyed Remaining Nephrons | Workload -Hypertrophy - |ability to concentrate urine Complete Renal Failure Transplant Dialysis -struction Hydroureter Hydronephrosis | Bladder = infection |Bladder = Acute or Chronic Renal Failure Kidney Stones Neurogenic Bladder nterruption of nerve supply Most common in pelvis of kidney Calcium or !hosphate 75- 80 % of the time Gender Race Geographic Location Seasonal Factors Fluid ntake Diet Occupation Upper Motor Neuron Lesion Lower Motor Neuron Lesion Loss of Voluntary control of voiding Loss of voluntary and involuntary control of voiding Lower Urinary Tract Obstructions Bladder Neck Dyssynergia !rostate Enlargement Urethral Stricture Severe !elvic Organ !rolapse Tumors Renal Bladder Wilms Tumor Embryonal Tumor Nephroblastoma Sporadic and inherited origins Associated with other anomalies UT Tumors Caused By Bacteria, Fungal and !arasite Cystitis Virulence of Uropathogens Host Defense Mechanisms !yleonephritis Most Common Site for UT Chronic Acute !eriurethral Mucus Secreting Gland Sphincter Mechanisms Bacterial Attaches to Uroepithelium Bacteria Form Biofilm Causes: E. Coli, Klebsiella, !seudomonas, Staph nfection initiates inflammatory response Renal Adenoma Renal Cell Carcinoma Bladder Tumors Body mmune System (Bladder Wall) ommon auses: Kidney Stones Vesicoureteral Reflux Pregnancy Neurogenic Bladder Instrumentation Female Sexual Trauma Benign Tumors Located near cortex of kidney Most common renal neoplasm !roximal tubule epithelial cells !rimary Associated with mutation of gene P53 Secondary Association: Tobacco Use, Obesity, Long-term Analgesic use ncrease Risk Result of invasion of cancer from bordering organs Smokers (men) Workers exposed to chemicals, rubber, & in textile industry Vesicoureteral Reflux Congenitally abnormal ureter Reflux of urine from bladder to kidney nfection, renal scarring, pyelonephritis PyeIonephritis Acute hronic nfection of renal pelvis and interstutium ommon auses Kidney Stones Vesicoureteral Reflux Pregnancy Neurogenic Bladder Instrumentation Female Sexual Trauma nflammatory !rocess damages tubular cells Usually localized abscesses Healing occurs Deposition of Scar tissue Atrophy of affected tubules Affects primarily the pelvis, calyces, and medulla Rarely causes renal failure Excretion of diluted urine mpairment of function Urine-concentration ability affected Destruction of tubules Areas of atrophy/dilation/ diffuse scaring nflammation and scarring of kidney !elvis, calyces dilated & blunted Recurrent Autoimmune nfections Renal Failure Common Cause: E Coli Glomerular Disorders Glomerulonephritis Nephrotic Syndrome Chronic Glomerulonephritis Crescentic Glomerulonephritis (Rapidly !rogressive) gA Nephropathy Berger Disease Acute Glomerulonephritis !roteinuria Lipiduria Hypocalcemia S/S Hematuria Red Blood Cell Casts !rotenuria | GFR Oliguria Edema HTN Abrupt onset 7-10 after infection Group A Strep S/S 10-21days after infections Most individuals Children recover with minimal loss of renal function Most Common Form Unknown cause 24-48 hrs after UR or G infection !rognosis variable 20-50% progress to Renal Fail diopathic !roliferative glomerular diseases Example of Crescent Glomerulo- nephritis Antiglomerular Basement Membrane (Good-pasture Syndrome) Antibody Formation Affects: !ulmonary Capillary Glomerular Basement Membs !oor !rognosis Renal Failure Several Glomerular Diseases Focal or Diffuse Segmental fibrosis and deterioration !oor !rognosis Tubular dilation and atrophy Cause: mmune response Toxin/Drugs Vasc. Disorders Damage: Biochemical Mediators of nflammation Complement activation Neutrophils/Monocytes Disturbance in Glomerular Basement Memb (metabolic, biochemical, physiochemical) leads to increase permeability to protein Hypoalbuminema Hyperlipidemia Treatment: Normal, Low-fat Diet; Salt Restriction Diuretics; Antigoagulants; Removal of toxins; Steroids; Albumin Replacements Structural Abnormality Definition Facts Hypospadias Congenital condition in which the urethral meatus is located on the ventral side of the penis Related to disruption in male hormones Accompanied by Chordee or penile torsion Corrective Surgery Epispadias Exstrophy of the bladder- Urethral opening on the dorsal surface of penis. Urethral opening small and situated behind the glans with fissure extending the length of penis Constant dribbling of urine Exstrophy of Bladder Extensive congenital anomaly in which the lower urinary tract is exposed directly to the surface of the body Caused by intrauterine failure of the abdominal wall and the mesoderm of the anterior bladder to fuse Reconstructive surgery girls teens Boys 2-3 yrs of age Ureteropelvic Junction Obstruction Blockage of the tapered point where the renal pelvis transitions into the ureter ntrinsic malformation of smooth muscle or urothelial development produces obstruction in 90% of cases. Causes kinking and scarring Bladder Outlet Obstruction A urethral valve is a thin membrane of tissue that occludes the urethral lumen and obstructs urinary outflow in males. !olyps rarely arise form the prostatic urethra often cause sever obstruction and impair renal embrogenesis leading to UT, Vesicoureteric reflux, and renal failure. Resection as soon as possible Hypoplastic(Dysplastic Kidneys Ureteric duct grows into the metanephric tissue, triggering the formation of the kidneys in utero. f this growth does not occur the kidney is absent or hypoplastic (small) Renal dysplasia results from abnormal differentiation of renal tissue Associated with a functional or organic obstruction of the collecting system Obstruction may begin prior to birth Renal Agenesis Absence of one or both kidneys !otter syndrome (bilateral renal agenesis) Clearly hereditary Bilateral agenesis is usually fatal Unilateral males more affected !olycystic Kidneys Autosomal dominant inherited disorder !KD-1 and !KD-2 mutations account for the disease The gene products regulate epithelial growth and differentiation. References Corwin, E. J. (2000). Handbook of !athophysiology (2nd ed.). !hiladelphia, !A: Lippincott. Gray, M., Huether, S., & Forshee, B. (2006). Alterations of renal and urinary tract function. n K. L. McCance & S. Huether (Eds.), Pathophysiology: The Biologic Basis for Disease in Adults & Children (pp.1301- 1336). St Louis, MO: ElSevier Mosby. Huether, S. (2006) Alteration of renal and urinary tract functions in children. n K. L. McCance & S. Huether (Eds.), Pathophysiology: The Biologic Basis for Disease in Adults & Children (pp.1337- 1351). St Louis, MO: ElSevier Mosby.