NR330 Renal8 ppt (1).pdf

RENAL SYSTEM Alterations in urinary function Prof. C. DePoy MSN-Ed RN RENAL STRUCTURE REVIEW Nephron Image: Curioscity: Science Show The kidneys job is to: Filter about 200L of fluid every 24 hours Cleanse the blood of toxins Transform waste into urine Help regulate Blood Pres...

RENAL SYSTEM Alterations in urinary function Prof. C. DePoy MSN-Ed RN RENAL STRUCTURE REVIEW Nephron Image: Curioscity: Science Show The kidneys job is to: Filter about 200L of fluid every 24 hours Cleanse the blood of toxins Transform waste into urine Help regulate Blood Pressure Things to keep in mind about kidney filtration: The layers of the glomerulus are negatively charged In Biology same charges repel each other so can not readily pass through basal membrane of glomerulus 1. Name Negatively charged particles 2. Name Positively charged particles Creatinine is the breakdown product of skeletal muscles Glomerular filtration is amount of fluid or plasma volume per every one minute. Normal GFR is 90-125ml/min The kidneys filter about 180L/day The rate depends upon age, size, sex, and kidney anatomy and function https://www.kidney.org/ CREATININE Creatinine is a more reliable indicator of renal function than BUN because it is less influenced by other factors such as diet and hydration. Mesangial cells Pushes water and solutes out of blood across filtration Glomerular Hydrostatic membrane Pressure Influenced by proteins in the blood, trying to pull H2O Osmotic Pressure back into the blood stream Draining filtrate pushes back into glomerulus Capsular Hydrostatic Pressure Should be ZERO. There shouldn’t be plasma proteins Capsular Osmotic Pressure filtering across the glomerular membrane ACUTE KIDNEY INJURY SUDDEN SHORT TERM KIDNEY DYSFUNCTION CAN BE REVERSED CAN LEAD TO CHRONIC KIDNEY DISEASE 1. PRE-RENAL: OBSTRUCTION, LOW CARDIAC OUTPUT, HYPOTENSION 2. INTRA-RENAL: INFECTIONS, CT CONTRAST DYE, DRUGS, CREATININE >1.3 3.POST RENAL: KIDNEY STONE, BPH, TUMOR CHRONIC RENAL FAILURE Long term kidney disease leading to dialysis, requiring transplant Chronic renal failure is measured in stages of decreasing GFR. 1. 90 GFR 2. 89-60 GFR 3. 59-30 GFR 4. GFR 29-50 5.