14. What are the principle physiological functions of the human kidneys?

The body depends on kidneys to excrete many waste products and to maintain the correct balance of water and saltes. The main functine – urine-forming function. The kidney participates in whole-body homeostasis, regulating acid-base balance, electrolyte concentrations, extracellular fluid volume, and regulation of blood pressure. The kidney accomplishes these homeostatic functions both independently and in concert with other organs, particularly those of the endocrine system. Various endocrine hormones coordinate these endocrine functions; these include renin, angiotensin II, aldosterone, antidiuretic hormone, and atrial natriuretic peptide, among others.

Many of the kidney's functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in the nephron. Filtration, which takes place at the renal capsule, is the process by which cells and large proteins are filtered from the blood to make an ultrafiltrate that eventually becomes urine. The kidney generates 180 liters of filtrate a day, while reabsorbing a large percentage, allowing for the generation of only approximately 2 liters of urine. Reabsorption is the transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.

15. What factors may cause kidney diseases?

Kidney disease may be caused by many factors, such as injury(causing a rupture of it’s surrounding capsule and leading hemorrhage. Damaged kidney may be surgically removed), infection(this may result in various kidney disease such as nephritis, glomerulonephrytis, pyelonephritis). Infection of the kidney often results from spread of infection from the urinary bladder.), cancer or disorders in other parts of the body(high blood pressure gradually damage kidneys). In some cases kidney diseases may occur without an apparent cause.

Stones may term in the kidney and cause it’s damage. This may occur without apparent cause or due to some metabolic disorder. The stones of the ureter may cause the urinary obstruction. This may result in reversed pressure of the urine into kidney, producing progressive loss of function)Various hormone disorders such as parathyroid gland hyperactivity, cushing’s syndrome, and diabetes affect kidney function.

16. Name and define the diseases you know.

Calculi disease, acute renal failure, glomerular disease, renal artery occlusion, acute and chronic pyelonephritis. kidney stone – concretion formed in the kidney from dietary minerals in the urine. Kidney stone – nephrolitiasis, ureter – uretrolitiasis, bladder – cistolitiasis.

Renal failure – loosely include all forms of acute urinary suppression, generally secondary to acute parenchimal damage. infection(this may result in various kidney disease such as nephritis, glomerulonephrytis, pyelonephritis)

17. What are the symptoms and signs of the kidneys’ diseases?

The symptoms of kidney disease depend on the underlying cause. They vary according to stage of disease. Kidney disease may cause an increased amout of urine to be formed, leading to abnormally frequent urination. Or the formation of urine may be diminished , leading to abnormally infrequent urination. Some kidne diseases sich as acute nephritis may cause blood in the urine. Other symptoms of kidney diseases include acute abdominal pain and generalizes oedema, which is swelling due to the accumulation of water in body tissues. If both kidneys stop working completely, waste products accumulate in the body and poison the patient. This can be fatal and requires urgent medical attention.

18. What are the required analyses and examination procedures to establish the diagnosis if any kidney disorder is suspected?

Suspecting kidney disease can be investigated in various ways. Chemical testing of the urine detects the presence of abnormal substances. Examination of the urine through a microscope may detect blood or white blood cells resulting from infection. Tests that measure the amount of the urea and creatinine in the blood help detect kidney disease. Urinalysis 1)color – yellow(intensity – amount of water) 2)reaction – slightly acid (infection of bladder – alkaline) 3)albumine – not present 4)sugar – not found. Special gravity – amounts of wastes, sugar. Acetone or keton bodies – diabetes.

19. What may cause urinary obstruction? What is nephrolithiasis?(calculi)

Causes – dietary factors: low fluid intake, high dietary intake of animal proteine, sodium, fructose, oxalate, grapefruit juicem apple juice, cola drinks. Kidney stone – concreation formed in the kidney from dietary minerals in the urine

20. What are the clinical manifestations of the urinary obstruction? What is the treatment of this condition?

When a stone enters and obstructs the ureter renal colic occurs. This is characterized bu the excruciating pain which originates in (the side)the back of flank and radiates across the abdomen and to the groin, genitalia, inner aspect of the hip.there may be nausea, vomiting, sweating, frequency, urgency, chills and shocks.treatment to relive the severe pain non-steroid painkillers used also opoids are used. Therapy – surgical, litothripsy(Extracorporeal shock wave lithotripsy (ESWL) for removal of calculi), nephrolitotomy). Modification of predisposing factors can sometimes slow or reverse stone formation. Special diet required- increased fluid intake, of citrate reach foods (lemonade, orange juice), limiting sodium, vit.c, animal proteins, oxalates food(strawberries, nuts, cocoa, chocolate)

21. What measures should be taken to relieve the patient’s suffering from an exacerbation of nephrolithiasis?

When a stone enters and obstructs the ureter renal colic occurs. This is characterized bu the excruciating pain which originates in (the side)the back of flank and radiates across the abdomen and to the groin, genitalia, inner aspect of the hip.there may be nausea, vomiting, sweating, frequency, urgency, chills and shocks.treatment to relive the severe pain non-steroid painkillers used also opoids are used.?????

22. What is pyelonephritis? What is the difference between the acute and chronic pyelonephritis?

Pyelonephritis is a type of urinary tract infection (UTI) that affects one or both kidneys. Pyelonephritis is a bacterial infection of the kidney. It can be serious because of the important function of the kidneys and because the infection may enter the blood stream.both pyelonephritis considered to be a diseases caused by the bacterial infection. But patients with acute pyelonephritis have acute attacks of the disease.Syptoms usually subsidr within few days without any specific treatment. If attack is severe proper antibiotic treatment should be started. Most patients recover after few attacks but considerable proportion of cases there are repeated attacks, at irregular intervals. Between attacks – symptom-free. In case of chronic pyelonephritis – symptoms develop slowly

????