1. Urinary System

2. Secreted Substances Secreted Substances Hydroxybenzoates Hydroxybenzoates Hippurates Hippurates Neurotransmitters (dopamine) Neurotransmitters (dopamine) Bile pigments Bile pigments Uric acid Uric acid Antibiotics Antibiotics Morphine Morphine Saccharin Saccharin

3. Urinary System Reabsorbed Substances Reabsorbed Substances Glucose Glucose Amino acids Amino acids Phosphate Phosphate Sulfate Sulfate Lactate Lactate Succinate Succinate Citrate Citrate

4. Urinary System Filtration and Reabsorption of Water by the Kidneys Filtration and Reabsorption of Water by the Kidneys

5. Renal Failure Also known as kidney failure. Also known as kidney failure. Condition where kidneys fail to function adequately. Condition where kidneys fail to function adequately. Decrease in glomerular filtration rate. Decrease in glomerular filtration rate. Classification : acute and chronic renal failure. Classification : acute and chronic renal failure. Acute renal failure (ARF)is a rapid loss of renal function due to damage to the kidneys. Acute renal failure (ARF) is a rapid loss of renal function due to damage to the kidneys. Chronic renal disease is a progressive loss of renal function over a period of months or years. Chronic renal disease is a progressive loss of renal function over a period of months or years.

6. Renal Failure Problems encountered due to kidney failure: Problems encountered due to kidney failure: abnormal fluid levels in the body abnormal fluid levels in the body deranged acid levels deranged acid levels abnormal levels of potassium, calcium, phosphate, hematuria (blood in the urine) and (in the longer term) anemia. abnormal levels of potassium, calcium, phosphate, hematuria (blood in the urine) and (in the longer term) anemia. Uremia : urine in the blood, can affects every organ of the body as certain substances that accumulate in uremia are clearly toxic. Uremia : urine in the blood, can affects every organ of the body as certain substances that accumulate in uremia are clearly toxic.

7. Acute Renal Failure Resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products that are normally excreted by the kidney. Resulting in retention of nitrogenous (urea and creatinine) and non-nitrogenous waste products that are normally excreted by the kidney. Kidney cannot exert any significant excretory. Kidney cannot exert any significant excretory. If patient omit protein foods from diet, urea still produced because of metabolic breakdown of body’s own tissue proteins. If patient omit protein foods from diet, urea still produced because of metabolic breakdown of body’s own tissue proteins. Thus, protein level in plasma will rise. Thus, protein level in plasma will rise. Plasma bicarbonate will fall because acids are formed by oxidation of sulphur and phosphorus in protein. Plasma bicarbonate will fall because acids are formed by oxidation of sulphur and phosphorus in protein.

8. Chronic Renal Failure Results in changes in body fluids which occur due to progressive decrease in number of functioning nephrons. Results in changes in body fluids which occur due to progressive decrease in number of functioning nephrons. Clearence of urea and other metabolic waste will decrease. Clearence of urea and other metabolic waste will decrease. On the other hand, plasma concentrations of these substances will rise. On the other hand, plasma concentrations of these substances will rise. Kidney become less effective due to declination in number of functioning nephrons. Kidney become less effective due to declination in number of functioning nephrons. Patient is liable to develop deficiencies or excess of body fluid water and sodium. Patient is liable to develop deficiencies or excess of body fluid water and sodium.

9. Dialysis Dialysis is a process of removing substances such as water, salts, and waste products (from the body’s normal metabolism), which build up in patients with failing kidneys. Dialysis is a process of removing substances such as water, salts, and waste products (from the body’s normal metabolism), which build up in patients with failing kidneys. Used to provide artificial replacement for lost kidney function. Used to provide artificial replacement for lost kidney function. Principle Operation Works on principles of diffusion of solutes and convection of fluid across semi-permeable membrane. Works on principles of diffusion of solutes and convection of fluid across semi-permeable membrane. Blood flows by one side of a semi-permeable membrane, and a dialysate flows by the opposite side. Blood flows by one side of a semi-permeable membrane, and a dialysate flows by the opposite side.

10. Dialysis The concentrations of undesired solutes are high in the blood side. The concentrations of undesired solutes are high in the blood side. At dialysate side, concentration of undesired solution is kept low so that the dialysis process could occur continuously. This could be done by constant replacement of dialysate. At dialysate side, concentration of undesired solution is kept low so that the dialysis process could occur continuously. This could be done by constant replacement of dialysate. Two forms of dialysis : hemodialysis and peritoneal dialysis. Two forms of dialysis : hemodialysis and peritoneal dialysis.

11. Dialysis

12. Dialysis Mechanisms of Transport through the Membrane Diffusion (true dialysis) Diffusion (true dialysis) movement due to concentration gradient movement due to concentration gradient If concentration is higher in the blood and the species can pass through the membrane, transport occurs until the concentrations are equal If concentration is higher in the blood and the species can pass through the membrane, transport occurs until the concentrations are equal Slow Slow If dialysate concentration is higher, the flow goes toward the blood If dialysate concentration is higher, the flow goes toward the blood

13. Dialysis Convection Convection Massive movement of fluid across membrane Massive movement of fluid across membrane Fluid carries dissolved or suspended species that can pass through the membrane Fluid carries dissolved or suspended species that can pass through the membrane Usually as a result of fluid pressure (both positive and suction pressure) Usually as a result of fluid pressure (both positive and suction pressure) Principal means of water and electrolyte removal (ultrafiltration) Principal means of water and electrolyte removal (ultrafiltration) Can also remove water by adding glucose to dialysate (osmotic gradient) Can also remove water by adding glucose to dialysate (osmotic gradient)

14. Artificial Kidney Treatment with device like dialyzer (artificial kidney) will reduce accumulation of waste products and water. Treatment with device like dialyzer (artificial kidney) will reduce accumulation of waste products and water. Dialyzer temporarily replace the function of kidney. Dialyzer temporarily replace the function of kidney. Operates outside patient’s body. Operates outside patient’s body. Receives patients blood from cannulated artery via plastic tubing and dialyzed blood return by another plastic tubing to an appropriate vein. Receives patients blood from cannulated artery via plastic tubing and dialyzed blood return by another plastic tubing to an appropriate vein. Dialysate is an electrolyte solution of suitable composition where waste products diffused to it from blood. Dialysate is an electrolyte solution of suitable composition where waste products diffused to it from blood. Dialysis takes place across a membrane of cellophane. Dialysis takes place across a membrane of cellophane.

15. Artificial Kidney