Kidney Function and Anatomy

Indicates excess fluid intake, diuretic use, or kidney disease.

Possible indication of infection (pyuria) or vaginal cream use.

Suggests hemoglobin breakdown, red blood cells (RBC), or certain medications.

Possible sign of blood in the urine (gross hematuria), post-surgery, or medications.

Indicates dehydration, excess bilirubin, or certain medications.

A measure of the concentration of dissolved substances in urine. It reflects how well the kidneys are diluting and concentrating urine.

High fluid intake results in lower urine specific gravity (more diluted urine).

Patients with kidney disease often have fixed urine specific gravity, meaning it doesn't change with fluid intake. This indicates impaired concentration.

A more accurate measure of the kidney's ability to dilute and concentrate urine compared to specific gravity.

The normal range for urine osmolality is 280 to 300 mOsm/kg. It reflects the kidney's ability to regulate solute concentration.

Escherichia coli is the most frequent cause of pyelonephritis.

Enterococcus fecalis is frequently found in hospitalized patients with pyelonephritis.

Other organisms associated with pyelonephritis include Proteus mirabilis, Klebsiella, and Pseudomonas aeruginosa.

Staphylococcus aureus, Candida species, and Salmonella species are common culprits in bloodborne pyelonephritis.

X-ray of the kidneys, ureters, and bladder (KUB) and IV urography are commonly used.

A test that evaluates hydration status. An elevated ratio indicates hypovolemia. A normal ratio with elevated BUN suggests intrinsic kidney disease.

A condition where the bladder is unable to fully empty, leading to a sensation of fullness, dribbling urine, dysuria, and bladder retention.

Involuntary leakage of urine during activities that increase abdominal pressure, such as coughing, sneezing, or exercising.

Sudden, uncontrollable urge to urinate, often resulting in urine loss before reaching the toilet.

Factors that can contribute to urinary problems include female gender, diabetes, pregnancy, neurological disorders, gout, decreased immune defenses, incomplete bladder emptying, inflammation of the urethra, instrumentation of the urinary tract, congenital abnormalities, and compression of the ureters.

The underlying mechanisms that cause urinary problems include factors such as inflammation, infection, obstruction, nerve damage, and muscle weakness.

Urinary problems are common and costly, often leading to significant functional, physical, and psychological changes that reduce quality of life.

While life-threatening complications are rare with urinary problems, they can still occur and should be addressed promptly.

A serious condition resulting from kidney failure where waste products build up in the blood, leading to various symptoms like fatigue, nausea, and muscle cramps.

Chronic kidney disease (CKD) progresses through 5 stages based on the estimated glomerular filtration rate (GFR), which measures how well the kidneys filter waste.

Uremia manifests with various symptoms like metallic taste, nausea, muscle cramps, fatigue, and edema, indicating the body's struggle to eliminate waste.

Glomerular filtration rate (GFR) measures how well the kidneys filter waste products from the blood. A low GFR indicates impaired kidney function.

Chronic kidney disease (CKD) is a progressive loss of kidney function over time, eventually leading to kidney failure if not treated.

End-stage kidney disease (ESKD) is the final stage of CKD, often caused by hypertension (high blood pressure) or diabetes.

People with uremia need to restrict their intake of fluids, protein, and electrolytes to help manage waste buildup and maintain a healthy balance.

Renal replacement therapy, such as dialysis or kidney transplant, is necessary when the kidneys can no longer function properly and is a life-saving intervention.

Deep, rapid breathing often seen in severe metabolic acidosis, a complication of CKD.

Lung inflammation and fluid buildup that can occur in patients with CKD due to waste buildup in the body.

A grating sound heard during breathing caused by inflammation of the pleura, the lining of the lungs.

Used to treat CKD when neurological problems arise, helping to remove waste and restore brain function.

Excess fluid in the body due to impaired kidney function, leading to hypertension, heart failure, and edema.

Decreased red blood cell count due to impaired erythropoietin production by the kidneys.

Increased bruising, petechiae, and bleeding due to impaired platelet function and blood clotting.

Routine blood tests include levels of electrolytes (calcium, phosphate, bicarbonate), hemoglobin, and hematocrit to monitor kidney function.