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idney Posterior abdominal wall outside peritoneal cavity Nephron functional unit of the !idney Function Filtration Reabsorption "ecretion #ormone production $ongentital disorders #ypospadias %pispadias $ystic disease &ilm's (umor Agenesis and hypoplasia of the !idneys #ypospadias %pispadias Polycystic !idney disease &ilms (umor Bilateral Renal agenesis ) Potters syndrome *aternal Oligohydramios Facial abnormalities Other congenital defects #orseshoe !idney Obstructive +isorders Renal calculi or Nephrolithiasis $alcium o,alate or $alcium phosphate -./012304
-6/04
$linical *anifestations of Kidney "tones Pain Flan!5 $7A5 or groin #ematuria 8ntravenous Pyelogram Obstructive disorders Other causes of obstruction (umors5 trauma5 edema5 pregnancy5 BP#5 98 inflammatory processes $onse:uences of obstruction 8nfection #ydronephrosis
Neurogenic bladder Functional obstruction not mechanical 8nterruption of the nerve supply to the bladder *ay be due to $N" or spinal cord dysfunction
Renal (umors Renal adenomas and Renal $ell $ancer $linical *anifestations #ematuria Flan! pain Palpable flan! mass &eight loss
Bladder (umors Ris! factors "mo!ing &or! in chemical5 rubber and te,tile industry &omen who ta!e Phenacetin $linical *anifestations Often asymptomatic #ematuria Urinary fre:uency ; pelvic pain
Urinary tract infections $ysitis Usually bacterial -e1coli4 *ore common in women ")" dysuria< urgency< fre:uency< cloudy5 foul smelling urine -may be asymptomatic4 Pyelonephritis Acute vs= chronic
9lomerular +isorders Acute 9lomerulonephritis #ematuria5 protienuria5 decreased 9FR5 oliguria5 edema5 #A5 #(N &ith t, high rate of full recovery Rapidly progressive glomerulonephritis -RP9N4 9oodpastures syndrome $hronic 9lomerulonephritis
Nephrotic "yndrome %,cretion of >=/ g or more of protein in urine per day +amaged glomerular membranes allow large losses of serum protein %dema5 hyperlipidemia5 lipiduria5 hypoalbuminemia5 proteinuria Acute Renal failure ARF Abrupt reduction of renal function with an accumulation of nitrogenous wastes in blood= $lassifications Prerenal 8nfrarenal Postrenal
$linical *anifestation of ARF (hree phases Oliguria +iuresis Recovery .30 return to full renal function Outcome dependant upon early intervention
$hronic renal failure $hronic and progressive loss of nephrons No symptoms apparent until renal function is less than ?/0 of normal $linical *anifestations Uremia accumulation of to,ins in plasma #ypertension5 anore,ia5 n;v5 diarrhea5 weight loss5 pruritus5 edema5 neurologic changes