Khawla has Complications

Khawla has Complications

1. Renal filtrarion

   • filtration barrier
     • Capillary endothelium fenestrated
       • Basement membrane homogeneous negativity charged glycoprotein/ mucopolysaccharide
         • capsular epithelial - podocytes & foot processes
     • Composition of filtrate depends filtration barrier
       • Easily filtered
         • Major Electrolytes: Metabolic waste products: metabolites; non-natural substances; inulin; PAH (p-aminohippric acid); law weight protein & peptides
           • Not freely filtered
             • Albumin and other plasma protein; lipid-solubale substances transported in the plasma attached to protein such as; lipid soluble bilirubin; T4 (thyroxine); other lipid-soluble hormones; unbounded lipid-soluble substances such as free cortisol are filtered and can appear in the urine

2. Kidney anatomy

   • Retro-peritoneally in the posterior abdominal wall by the side of the vertebral column
     • T12 to L3 vertebrae
       • Renal coverings
         • 1 fibrous capsule. 2 perinephric fat. 3 renal fascia. 4 paranephric fat

3. Classification of renal diseases

   • Chronic
   • Acute

4. edema

   • generalized
     • Cardiac failure
     • Nephrotic syndrome
   • Organ specific
     • Nephrotic syndrome
     • Lymph obstruction
     • Contact dermatitis
   • Causes
     • increased hydrostatic pressure
     • increased tissue colloidal or oncotic pressure
     • Obstruction of fluid clearance in the lymphatic system
     • increased blood vessel wall pemeability (e.g inflammation)
     • reduced colloidal or oncotic pressure within blood vessels

5. proteinuria

   • High fever
   • Orthostatic proteinuria (in children)
   • After vigorous exercise
   • early in morning dehydration
   • Congestive heart failure
   • Urinary tract infection
   • glomerular pathology (e.g gloverulonephritis or diabetes)

6. NEG of vascular basement membrane leads to hyaline arteriolosclerosis

   • High filtration injury that leads to sclerosis of mesanguim
   • Diabetic nephronpathy
     • signs & symptoms
       • Nausea & vomiting
       • loss of appetite
       • Worsening blood pressure control
       • confusion of difficulty concentrating
       • swelling of feet, ankles, hands, or eyes
       • increased need to urinate
       • protein in the urine

7. investigation of kidney disease

   • nitrites, lukocytes esterase
   • Hematuria
   • color clarity gravity
   • glucose ketones
   • bilirubin urobiligen
   • proteinrea
     • glomerular
     • overflow
     • tubular
     • functional

8. staling forces which determine GFR or glumerular filtration rate

9. Treatment

   • dialysis
   • kidney - pancreas transplant
   • diet monitering
   • medication
     • ACE inhibitors & ARBs are mainly the only drugs that actually slow down the the progression of nephewrophathy

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