What are some disorders of the

urinary

system?

How are disorders of the urinary

system

treated?

How do you relate the body’s

hormone

control to the urinary system?

4.02 Understand the disorders of the urinary system

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DISORDERS OF THE URINARY SYSTEM

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CYSTITIS What is cystitis cyst= medical term for ____ + itis =___ Inflammation of the mucous membrane

lining of the urinary bladder Most common cause is the bacteria E. Coli, which is normally found in the rectum.

Yikes!! How’d that happen?

MORE ON CYSTITIS... Another cause might be from

urethritis or inflammation of the urethra, which usually leads to painful urination (dysuria) and/or frequent urination (polyuria)

Occurs more often in females; due to short urethra of 1.25 – 2 inches long

The short urethra provides easy entry for organisms from outside the body

Treatment includes antibiotics, urinary antiseptics and increased intake of fluids.

Additional preventative measures require teaching the patient the proper technique for wiping after urination

Also prevention includes reminding the patient to complete all the antibiotics to avoid reinfection.

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An inflammation of the glomerulus

(glo mer u lus) of the nephron

Two types:Acute – the inflammation is due to a bacterial infection

Chronic – diminished function of the kidney due to damage to the filtration membrane

GLOMERULONEPHRITIS

ACUTE

bacteria

Symptoms

(albuminuria)

Occurs in some children abt 1 – 3 weeks after a bacterial infection, usually a strep throat. Develops quickly.

Treated with antibiotics with recovery.

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CHRONIC GLOMERULONEPHRITIS

The chronic form may develop silently (without symptoms) over several years.

Occurs when the filtration membrane becomes permanently damaged.

Early signs and symptoms of the chronic form may include: - Blood or protein in the urine (hematuria, proteinuria) - High blood pressure - Swelling of your ankles or face (edema) - Frequent nighttime urination - Very bubbly or foamy urine - Diminished functioning of the kidneys - It often leads to complete kidney failure.

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RENAL CALCULI Also known as nephrolithiasis (nephro lith iasis) aka kidney stones Accumulation of crystals of calcium phosphate, along with uric acid and other substances that clump together Slowly grow in size Fill renal pelvis, obstruct urine flow in the ureters Symptoms include extreme pain, occurs suddenly in the area of kidney and move to groin area May have nausea/vomiting, burning, frequent urge to void, chills, fever, weakness, maybe hematuria Diagnosis by symptoms, ultrasound, x-rays Treatment includes increase of fluids to flush out, meds to dissolve the stone If not resolved a urethroscope or lithotripsy may be done

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RENAL CALCULI

What will happen if the ureters are blocked?

Hydronephrosis – the distention of the renal pelvis and calyces due to the accumulation of fluid

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aka ESWL extracorporeal shockwave lithotripsy Uses shockwaves created outside the body to travel thru skin

and body tissue until it hits the stones causing them to break up They can then pass out thru the urine flow Is it a cure? No, may need to be done repeatedly.

LITHOTRIPSY

URETEROSCOPIC STONE REMOVAL

Dimension du calcul : - Longueur : 11cm (length)- Largeur : 9cm (width)- Epaisseur : 8cm (thickness)- Poids : 2Kg (weight) 1 kilogram is equal to 2.20462262185 lb

Acute or Chronic

RENAL FAILURE

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RENAL FAILURE

Acute May be sudden onset Cause varies: nephritis, shock,

injury, bleeding, sudden heart failure, or poisoning

Symptoms include: oliguria, anuria and uremia

Uremia symptoms: h/a, dyspnea, n/v, extreme cases – coma and death

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RENAL FAILURE

Chronic Gradual loss of nephron function There may not be any symptoms for a long

while Can take months to years to occur It may be so slow that by the time

symptoms appear and are detected less than 1/10th of kidney function is happening

Final stage called End-Stage Renal Disease or ERSD

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RENAL FAILURE

Renal Failure Chronic kidney

disease leads to a buildup of fluid and waste products in the body.

How are these systems affected by renal failure?

RENAL FAILURE – SYSTEM SYMPTOMS Nervous System - drowsy, confused - issues concentrating or thinking - numbness hands, feet, other

areas - muscle twitching or cramps Respiratory System - shortness of breath Digestive System - weight loss without trying - frequent hiccups - nausea - breath odor - excessive thirst - blood in stool - vomiting, typically in the morning

Urinary System - build up of fluid and waste - inability to urinate - urinalysis may reveal

proteinuria Integumentary System - itching (pruritus) - dry skin - abnormally dark or light skin - easy bruising - easy bleeding - edema (swelling) feet and

hands

DIAGNOSIS

Urinalysis Creatinine

clearance Creatinine levels BUN

Changes seen in the following: - albumin - calcium - cholesterol - CBC - electrolytes - magnesium - phosphorus - potassium - sodiumAND MORE…..

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RENAL FAILURE

Treatment option: P e r i t o n e a l d i a l y s i s Serves as a substitute kidney Uses the patient’s own peritoneal

lining to filter the blood Dialysate placed in abdomen via

catheter Fluid, wastes, electrolytes and

chemicals pass from capillaries in the peritoneal membrane into the dialysate

After several hours drained from abdomen taking waste from blood out

Process takes about 30 minutes and done about 4 times a day

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RENAL FAILURE Treatment option:

Hemodialys is Serves as a substitute

kidney Involves passage of blood

thru a device that removes harmful wastes, extra salt and water

Usually done 2 to 3 times a week for 2 to 4 hours

Patients are asked to eat a special diet and take prescribed meds

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RENAL FAILURE

Compare the treatment of acute and chronic renal failure.

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HEMODIALYSIS

How does hemodialysis mimic glomerular function?

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RENAL TRANSPLANT What is involved in this

treatment option? - done in cases of prolonged chronic debilitating disease with renal failure of BOTH kidneys - typical patient has been on dialysis for a long period of time waiting for

a compatible organ

Two types of transplants: - donor from a living donor (a matching family member, usually) - donor of unrelated person who has

died - blood and other cellular material must match from donor to recipient

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RENAL TRANSPLANT

What is the major complication of renal transplantation?

REJECTION… Medication must be taken everyday to prevent

rejection The maintenance agents are generally 4 classes of

drugs called immunosuppressants: - Calcineurin Inhibitors: Tacrolimus and Cyclosporine - Antiproliferative agents: Mycophenolate Mofetil, Mycophenolate Sodium and Azathioprine - mTOR inhibitor: Sirolimus - Steroids: Prednisone