1. Kidney Problems

2. Introduction
The body needs the kidneys to be functioning properly in order to maintain homeostasis.
Kidneys are very connected with other body systems (i.e. Urinary System), that if one is affected, the other will be affected as well.

3. Urinalysis and Blood Tests
Urinalysis is the examination of the characteristics of urine (i.e. colour, odour, taste…).
It can give clues as to kidney function.
Blood tests can also provide info as to kidney function and make sure urea is being released.

4. Problems that affect the Kidneys

5. Urinary Tract Infections (UTIs)
UTIs are a viral or bacterial infection of the urinary tract.
Symptoms include painful urination, pain in the abdomen, fever…
If not treated with antibiotics/drugs, the infection may move up to the kidneys.
Affects females more than males.

6. Diabetes Insipidus
Not to be confused with traditional diabetes which is an inadequate supply of insulin.
Diabetes insipidus is a destruction in the ADH producing cells of the hypothalamus.
No ADH means less water reabsorbed and therefore increased urine output and massive thirst.

7. Kidney Stones
Kidney stones are caused by the precipitation of mineral salts (usually Ca) in the kidney.
Recurrent UTIs, insufficient water consumption and low activity can lead to kidney stones.
Usually pass naturally (and painfully!), but can require surgery if larger.
Also can use ultrasound (or ESWL)to blast stones into smaller pieces more easily able to pass through.

8. Nephritis (Bright’s Disease)
A broad category of diseases associated with an inflammation of the nephrons.
Usually caused by infection.
Alters the filtration of the glomerulus and thus, the formation of urine.
Various degrees of pain and thus varying degrees of treatment (i.e. skim milk treatment).

9. Renal Insufficiency
Renal insufficiency is the general term to describe a state in which kidneys’ cannot maintain homeostasis.
Nephrons can recover from short term injuries.
A person can survive with 1/3 of one kidney!
However if ~75% of the nephrons are destroyed, urine output is too low to maintain homeostasis and a kidney transplant or dialysis is required.
Causes of Renal Insufficiency:
Kidney infection
High Blood Pressure
Diabetes
Polycystic Kidney Disease (PKD)
Trauma or constant vibration
Poisoning
Atherosclerosis

10. Dialysis
Dialysis is the diffusion of dissolved substances through a semi-permeable membrane.
It is used to remove wastes and fluid from the blood when kidney function is lost to renal failure.
Substances are moved from the blood into the dialysis solution (dialysate) and vice versa.
There are two types of dialysis.

11. Hemodialysis
Hemodialysis uses an external machine with a membrane (essentially an artificial kidney) that is connected to an artery and a vein.
It removes the wastes and puts essential solutes back into the blood, like a kidney would.
Must be done 3-4 times a week and takes 3-5 hours each time.

12. Peritoneal Dialysis
Peritoneal dialysis uses the lining of the intestines (peritoneum) as the dialysis membrane.
The dialysate is put into the intestinal cavity where the large surface area and rich supply of capillaries of the peritoneum slowly filter the blood.
Then the waste is siphoned out.
It is done 3-5 times a day!

13. Kidney Transplants
Dialysis can allow a person to continue many of the daily life activities, however it is not a cure.
If a person has less than 10% of their kidney function, they will need a transplant.
Unfortunately, in Canada, the donation rate (14 per million people) is much lower than the need and so about 75% of people needing a kidney are still waiting for one.
Success rate of kidney transplants are between 95-98%.
Rejection of kidneys is becoming more rare as anti-rejection drugs and screening of donors are improving.

14. Homework
Read pages
Questions p. 362 #1, 2, 5, 7 and 10.