Disorders of Urinary System PDF

Disorders of Urinary System Dr Iram Jaan Lecturer, Physiology www.gmu.ac.ae COLLEGE OF HEALTH SCIENCES Nephron: Structural and functional unit of kidney Glomerular Filtration Rate (GFR): the rate at which plasma is...

Disorders of Urinary System Dr Iram Jaan Lecturer, Physiology www.gmu.ac.ae COLLEGE OF HEALTH SCIENCES Nephron: Structural and functional unit of kidney Glomerular Filtration Rate (GFR): the rate at which plasma is filtered by the kidney glomeruli Normal value 125 ml/min Tubular reabsorption and secretion  Common disorders of urinary system ❖ Analgesic neuropathy: Long term use of pain relievers particularly nonsteroidal anti-inflammatory drugs (NASAIDs) Ibuprofen, naproxen particularly when combined with caffeine ❖ Chronic renal failure: Progressive kidney diseases Progression can be controlled by treating underlying causes like hypertension, high cholesterol End stage renal failure can only be treated with dialysis/renal transplantation  Common disorders of urinary system ❖ Diabetes insipidus Too little ADH, insensitive kidney to ADH Large urinary output. Patients often become dehydrated Chances of brain damage due to low sodium level ❖ Glomerulonephritis Inflammation of the glomerulus Damage of filter Blood, Blood cells appear in the urine (hematuria) Decreased removal of waste products, loss of electrolyte balance ❖ Diabetic nephropathy Having high blood glucose levels due to diabetes can damage the part of the kidneys that filters the blood The damaged filter becomes leaky and leads to proteinuria and glycosuria  Common disorders of urinary system ❖ Kidney stones (Renal calculi/ Nephrolithiasis/ Urolithiasis) This is a condition where hard deposits made of minerals and salts are formed in the kidneys ❖ Polycystic kidney disease (PKD) Clusters of cyst develop primarily in the kidneys leading to gradual kidney damage Case 1 A 60-year-old man was presented with swelling in his arms and legs, increased need to urinate, fatigue, blurry vision, foot sores and extremely high blood pressure. His medical history reveals long term poorly controlled diabetes. Following the routine kidney tests, he was diagnosed with diabetic nephropathy. Briefly explain the pathophysiology of diabetic nephropathy? In which part of the nephron does the glucose reabsorption occur? Define renal threshold of glucose with the approximate physiological value. Case 2 A 45-year-old woman complained of severe, sharp pain in the side and back of the abdomen, as well as below the ribs, burning sensation while urinating, a persistent need to urinate and consistent fever. After undergoing urine tests, blood tests and imaging, she was diagnosed having kidney stones. What are kidney stones? Discuss the main causes of kidney stones? List the steps in order that are involved in the formation of urine in a healthy kidney. Case 3 A 60-year-old man was suffering from unexplained fatigue, thirst and very frequent urge to urinate. The doctor has performed routine kidney function tests, along with water deprivation test and blood test to assess the levels of antidiuretic hormone (ADH). The patient was observed to have very low levels of ADH in blood as compared to the normal value. The water deprivation test involves not drinking any liquid for several hours, but still he continued to urinate large amounts of dilute urine when a healthy human would urinate only a small amount of concentrated urine. Given the above symptoms and observations, what can be the most possible diagnosis? In which parts of the nephron do the antidiuretic hormone (ADH) act on? What is the function of ADH in urine formation? Learning Resources Textbook: Colbert BJ, Ankney J, Lee KT. Anatomy and Physiology for health professions. 2nd edition, Pearson education; 2011. ISBN-13: 978-0-13-506077-3. Chapter 17, pp. 446-449. www.gmu.ac.ae COLLEGE OF HEALTH SCIENCES