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Published byViolet Shepherd Modified over 9 years ago
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22 September 2015
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Paired retroperitoneal structures Filtration and excretion of metabolic waste products Regulation of electrolytes, fluid, and acid-base balance Stimulation of RBC production
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Renal calculi A common cause of renal failure Supersaturation of the urine by stone-forming constituents Calcium, oxalate, and uric acid Dehydration, low fluid intake
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Kidney stones can cause kidney damage in two primary ways An untreated obstructing stone that causes persistent severe blockage Infection related stones can lead to ongoing chronic urinary tract infections that cause damage slowly through inflammation and scarring of the kidney tissue
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Pain Hematuria UTI Renal failure Asymptomatic
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Urine examination Plain KUB BUN, Creatinine IVP CT scan
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Conservative, medication ESWL ( extracorporeal shockwave lithotripsy ) RIRS ( retrograde intrarenal surgery ) PCNL ( percutaneous nephrolithotomy ) Open Sx ( Anatrophic nephrolithotomy, Pyelolithotomy ) Nephrectomy
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Percutaneous nephrolithotomy PRS : Percutaneous Renal Surgery A minimally invasive technique to access the kidney to remove large stones (>2cm) or stones Small puncture wound
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Blockage of the flow of urine out of the body Common cause of acute and chronic renal failure Intrinsic and extrinsic cause Urine stasis, infection, stone formation, anatomical changes, renal deterioration
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Post-renal renal failure Supravesical obstruction (Bilateral ureteral obstruction) infravesical obstruction (Bladder outlet obstruction) Hydronephrosis Surgical anuria Overflow incontinence
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Underlying diseases Previous renal function Signs of CKD LUTS History of KUB stone
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CBC BUN, Cr., electrolyte UA Plain KUB Ultrasound
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Hydronephrosis : a hallmark of urinary tract obstruction Measurement of kidney size and echogenicity as part of an evaluation of chronic kidney disease No exposure to radiation Interpretation is operator-dependent
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Urinary diversion Foley catheter Intake, output monitoring Nephrotoxics avoidance Electrolyte imbalance
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A surgical procedure that reroutes the normal flow of urine out of the body Urine cannot flow out of the body External diversion (nephrostomy) Internal diversion (double J stent)
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A blockage at the base of the bladder that reduces or prevents the flow of urine BPH, Urethral stricture, Urethral calculi LUTS (lower urinary tract symptoms) Mechanical, Functional Foley catheter
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