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KIDNEY
á The kidney is a reddish brown in color, shaped
like a kidney bean.
á 4µinch long 2µwide

á Weight: less than ½ a lb

á About the size of a human fist.

á The upper lobe is called the superior lobe

á The lower lobe is called the inferior lobe

KIDNEY
á Renal Capsule, a layer of fibrous connective
tissue, surrounds the kidney.
á Renal Cortex a thin layer of tissue just below the
renal capsule.
á Renal Medulla is the rest of the tissue beneath
the cortex.
Y contains the triangular shaped renal pyramids
á Minor calix: tip of each renal pyramid; duct
that drains urine
á Major calix: minor calix drains into the
major calix; drains into renal pelvis.
á Renal Pelvis is a large funnel shaped cavity on
the medial side of the kidney. The inferior part of
the renal pelvis narrows and becomes the ureter.
VRETERS
á Vreters: 12µin tube that extends from the renal
pelvis of the kidney to the bladder.
á Vreteral orifice: the openings where the ureter
joins the bladder.
á Peristalsis: process where the smooth walls of the
ureters contract every 30 seconds to propel urine
into the bladder.
| ADDER
á A reservoir for storing urine, located in the pelvic cavity.
á Fundus (dome): rounded top of the bladder.
á Mucosa: mucous membrane that lines the bladder.
á Rugae: folds when mucosa collapses when the bladder is
empty.
á Trigone: triangular area between the two ureteral orifices
and the bladder opening.
á |ladder Neck: base of the bladder that connects to the
urethra.
á Sphincter: muscular ring located at the base of the bladder
that allows urine to flow into the urethra; involuntary
reflex.
VRETHRA
á Vrethra: tube that carries urine from bladder to outside of
the body.
á External Vrethral Sphincter: ring of voluntary muscles
located at the end of the urethra; ability to consciously
control the release or holding back urine.
á Prostate Gland: spherical gland at the base of the bladder.
á Penile Vrethra: urethra that travels the length of the penis
until it reaches the external surface of the body.
á Vrethral Meatus: where the urethra opens to the outside
of the body.
á In women the urethra is much shorter, traveling only 1 to 2
inches from the bladder to the external surface of the body.
FVNCTIONS OF THE VRINARY SYSTEM
á Kidneys
Y Regulates blood volume, blood pressure, pH balance
in the blood, production of red blood cells, synthesis
of Vitamin D, and excretes waste products and
foreign substances.
á Vreters
Y They transport urine from the renal pelvis to the
bladder
á |ladder
Y Provides a storage place for urine
Y Expels urine into the urethra by micturition(also
known as urination)
á Vrethra
Y Passageway in which urine is expelled from the body
FVNCTIONS OF THE VRINARY SYSTEM
á Nephron
Y Functional part of the kidneys that include 3 main
parts
1. Filtration
2. Re-absorption
3. Excretion
RENA DIET
á imit Fluid Intake
Y Renal failure surrenders the body unable to rid itself
of fluid, resulting in Edema, SO|, and Elevated |P
á imit Potassium Intake
Y Kidneys help correct potassium levels in the body.
Failure may cause increased levels resulting in
irregular heart beat and other cardiac problems can
develop
á imit Protein and Sodium
Y Renal failure doesn·t allow the kidneys to filter
protein causing a buildup of protein in the blood.
Sodium the kidneys aren·t able to excrete sodium
leading to water retention
á The amount is chosen for specific patient needs
and specified by the MD
VRINARY INCONTINENCE
á Is any involuntary leakage of urine
á Some causes include polyuria, uncontrolled
diabetes mellitus, excessive drinking, caffeine or
cola beverages can stimulate the bladder
á There are 5 types of incontinence(stress, urge,
overflow, reflex, and functional
STRESS INCONTINENCE
á Is the loss of urine when there is pressure or
stress on the bladder. Some examples are
coughing, sneezing, laughing, and etcs
á It occurs due to the sphincter muscle of the
bladder is weakened.
á Treatment includes Kegel exercises, avoiding
bladder irritants such as caffeine or cola, and also
surgery
VRGE INCONTINENCE
á Is a sudden urge to urinate, following an
involuntary loss of urine.
á This is usually caused by bladder cancer, bladder
inflammation, an obstruction in the bladder,
bladder stones, and an infection
á In men this can be caused by benign prostatic
hypertrophy
á Symptoms include polyuria in the day and night,
loss of urine, an urge to urinate
á Treatment would be taking anticholinergic meds
to relax the muscles of the bladder, Kegels
exercise and surgery
OVERF OW INCONTINENCE
á Inability to empty your bladder completely. This
usually occurs in people with a damaged bladder,
blocked urethra or even prostate gland problems
in men
á Treatment would be use of catheterization due to
the patient not being able to fully empty the
bladder
REF EX INCONTINENCE
á Is the inability to control the release of urine.
This occurs when a persons bladder contracts
without the person being able to stop it
á Treatment includes catheterization, having a
schedule time to urinate, and having pads
underneath or adult diapers.
FVNCTIONA INCONTINENCE
á This is cause due to the person not being able to
reach the restroom quickly enough to urinate,
this can be mostly seen in the elderly who aren·t
able to reach the toilet in time
á Treatment includes making the bathroom
accessible and the passageway to the bathroom
clear, wearing clothing that is easy to remove,
and by having someone assist you to the
bathroom.
VTI
á Vrinary Tract Infection (VTI) is an infection that
can happen anywhere along the urinary tract
á Symptoms include: Cloudy or bloddy urine, foul
or strong odor, polyuria, and pain in the Vrethra
á Cause is mostly due to bacteria

á A urinalysis is done to diagnosis to look for

bacteria
á Treatment would be to increase fluid intake or
take prescribed antibiotics
PYE ONEPHRITIS

á Inflammation of the kidney leading to edema

á Cause: E. coli organism (associated w/ diseases
such as DM and VTI
á Outcome could be atrophy of kidney and nephrons
PYE ONEPHRITIS-SIGNS AND SYMPTOMS
á Nausea, Vomiting
á Diarrhea, Hypertension

á Signs of Infection
PYE ONEPHRITIS-TREATMENT
á Rest & Comfort
á Intake & Output

á Promote fluid & Nutrition

á Medication: Antibiotics for infection

Y Antispasmodics for discomfort
VRO ITHIASIS
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VRO ITHIASIS- PATHOPHYSIO OGY

á Stone (calculi) crystals formed from materials

normally excreted in the urine.
á Most are made of calcium

á Phathophysiology
VRO ITHIASIS- RISK FACTORS
á Personal of family history
á Dehydration; excess calcium, oxalate, or protein
intake
á Gout

á Hyperparathyroidism

á Vrinary stasis (!
 )

á Immobility

á Alkaline Vrine
VRO ITHIASIS- SYMPTOMS
á Vrinary tract obstruction ² if develops slowly

Y Pain in the flank region

Y Pain in genitals

á Vrine production continues leading to an

increased pressure and distention
Y Hydronephrosis- abnormal dilation of the renal pelvis & calyces)
Y Hydroureter -distention of the ureter with urine
VRO ITHIASIS- DIAGNOSTIC TEST
á Vrinalysis
Y to detect hematuria
á KV| x-ray
Y to identify the presence of calculi
á IVP, Renal Vltrasound, CT Scan, MRI
Y to locate calculi
Y Identify hydroureter or hydronephrosis
Treatment
Y Analgesics
Y Pain relief
Y ithotripsy
Y ESW (extracorporeal shock-wave)
Y Nephrectomy
HYDRONEPHROSIS
á Abnormal dilation of the renal pelvis & calyces
á Vesicoureteral Reflux
Y backflow or urine from the bladder to ureters
á Pressure in the renal pelvis increases, and it
dilates
á Nephrons & collecting tubules may be damaged,
affecting renal function
HYDRONEPHROSIS-TREATMENT
á Vltrasound, CT scan, cystoscopy
á Immediate treatment involves reestablishing
urine flow from affected kidney
á Nephrostomy tube, ureteral stent, indwelling
catheter
Y Stent may be temporary or used for longer periods for
ureteral obstruction
Y Stent may be pigtail or J-shaped to keep it in place
PO YCYSTIC
á Hereditary disease characterized by cyst
formation & massive kidney enlargement
á Common disease affects children & adults

á Renal cyst in the nephron

á Fluid filled sacs range in size from microscopic to

several centimeters in diameter
á |oth kidneys are affected

á Cyst fill, enlarge & multiply ,and

the kidneys also enlarge
PO YCYSTIC-SYMPTOMS
á Cysts gradually destroy functional kidney tissue may
develop elsewhere
Y iver
Y Spleen
Y Pancreas
á Cardiac & vascular abnormalities may be present

á Slowly progressive in the 30s or 40s

Y flank pain
Y microscopic
Y gross hematuria
Y proteinuria
Y polyuria
Y nocturia
PO YCYSTIC
Treatment
á Management of adult polycystic kidney disease is
supportive
á Renal ultrasound done to diagnose

á Care is taken to avoid nephrotoxins, VTI,

obstruction & HTN
á Fluid intake 2,000 to 2,500m is encouraged
prevent VTI & lithiasis
á Ace inhibitor to manage HTN

á Hemodialysis or kidney transplantation

G OMERV ONEPHRITIS
á Glomerulonephritis is a type of kidney disease in
which the part of your kidneys that helps filter waste
and fluids from the blood is damaged.
á Symptoms include: Fever, Edema, hematuria,
decreased urine output, lethargy, and anemia
á Caused by specific problems with the body's immune
system. Often, the precise cause of glomerulonephritis
is unknown.
á Test include: Vrine Specific Gravity Test, |VN,
Creatinine Clearnance Test, Vrine Protein Screen,
and GFR
á Treatment woud include: Dialysis, |P management,
fluid restriction with dietary restriction, or a kidney
transplant
DIA YSIS
á Replaces the function of the kidneys, by the use
of a blood filter and a chemical solution known as
dialysate, this then removes waste products and
excess fluids from the bloodstream, while
maintaining the proper chemical balance of the
blood.
á Important abs needed to monitor are |VN, CR,
Potassium, phosphorous, calcium, magnesium,
hemoglobin and hematocrit are some of the labs
to monitor for pts on Dialysis
RENA FAI VRE
á The kidneys fail to remove toxins and waste
products from the blood. There are two types of
Renal failure(Acute and Chronic)
á Renal failure can be shown by a decrease in the
GFR (Glomerular Filtration Rate) and by an
elevated Creatinine level
á Renal failure is mostly seen in Patients with
Diabetes Mellitus and Hypertension
á One way to differentiate acute renal failure and
chronic kidney failure includes anemia and
kidney size on an ultrasound. Chronic kidney
failure usually leads to anemia and a small
kidney size
ACVTE RENA FAI VRE
á Sudden loss of the ability of the kidneys to
remove waste and concentrate urine without
losing electrolytes
á Symptoms include bloody stools, breath odor,
change in mental status or mood, flank pain,
high |P, metallic taste in mouth, decreased urine
output, and nocturia
á Diagnostic test include; |VN, Creatinine
clearance, serum creatinine and potassium, and
an Vrinalysis
á Treatment would include staying in the hospital
for treatment, high carb diet, and low protein,
sodium, and potassium diet, and dialysis may be
used depending on patient·s condition
CHRONIC RENA FAI VRE
á Is a loss of kidney function over time
á In early stages there may be no symptoms, they
usually occur until the kidney function is less than
one-tenth normal
á Final stage is end-stage renal disease, where the
kidney scan no longer function and patients needs
dialysis or a kidney transplant
á Diabetes and High |P are most common causes
á Symptoms include abnormal skin color(to dark or
light), bone pain, blood in stool, edema, sleep
problems such as insomnia
á abs include Creatinine levels, |VN, Creatinine
Clearance
á Treatment includes Preventing CRF by controlling
|P, No smoking, eat meals low in fats and cholesterol,
and by keeping blood sugar under control