A Hot Summer's Night

A Hot Summer's Night

1. Renal physiology

   • Kidney Function
     • Nephrons: the Functional unit of the kidney
       • A renal corpuscle, a renal tubal, and the associated capillary network, which originates from the cortical radiated arteries
   • Kidney structure
     • 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
   • Urine Formation
     • Filtration
       • 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.
     • Reabsorption
       • 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
         • 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.
         • Passive diffusion - passing through plasma membranes of the kidney epithelial by concerntration gradient
         • 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
     • Oligouria
       • < 400 ml/day
     • anuria
       • < 100 ml / day
     • Polyuria
       • < 2 L / day
     • Secretion
       • secretion accuses are similar of those reabsorption, however these process occur in the apposite direction
         • 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

2. Shock

   • a life-threatening condition that occurs when the body is not getting enough blood flow
     • Causes
       • Heart Problems
       • Changes in blood vessels
       • Low blood volume
     • Types
       • neurogenic
       • Sepsis
       • Hypovolemic
       • anaphylactic
       • Cardiogenic
     • Symptoms
       • Enlarges pupils
       • Weakness or fatigue
       • Nausea or vomiting
       • Rapid pulse
       • Dizziness
       • Rapid breathing

3. Acute Kidney Failure

   • Chronic Kidney failure
     • Causes
       • Diabetes
       • Hypertension
       • Policystitis
     • Caused by acute kidney failure
     • Manifestations
       • Chest Pain
       • Shortness of breath
       • Sodium & water balance
       • Metabolic acidosis
       • Anemia
       • Potassium balance

4. Investigations

   • Serum biochemistries
   • Urine analysis with microscope
   • Urine Electrolytes
   • CBC
   • Renal imaging is useful, especially if renal is secondary to obstruction
     • 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.
     • 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

5. Progosis

   • Depends on the causes on the disease
   • Partial recovery of renal function may occur in situation in which the injury does not completely resolve.