1. 4.02 Understand the disorders of the urinary system
What are some disorders of the urinary
system?
How are disorders of the urinary system
treated?
How do you relate the body’s hormone
control to the urinary system?

2. Disorders of the urinary system

3. Cystitis What is cystitis cyst= medical term for ____ + itis =___
Inflammation of the mucous membrane lining of the urinary bladder
Most common cause is the bacteria E. Coli,
which is normally found in the rectum. Yikes!!
How’d that happen?

5. More on Cystitis...
Another cause might be from urethritis or inflammation of the urethra, which usually leads to painful urination (dysuria) and/or frequent urination (polyuria)
Occurs more often in females; due to short urethra of 1.25 – 2 inches long
The short urethra provides easy entry for organisms from outside the body
Treatment includes antibiotics, urinary antiseptics and increased intake of fluids.
Additional preventative measures require teaching the patient the proper technique for wiping after urination
Also prevention includes reminding the patient to complete all the antibiotics to avoid reinfection.

6. Glomerulonephritis An inflammation of the glomerulus
(glo mer u lus) of the nephron
Two types:
Acute – the inflammation is due to a bacterial infection
Chronic – diminished function of the kidney due to damage to the filtration membrane

7. ACUTE bacteria Symptoms (albuminuria)
Occurs in some children abt 1 – 3 weeks after a bacterial infection, usually a strep throat. Develops quickly.
bacteria
Symptoms
(albuminuria)
Treated with antibiotics with recovery.

8. Chronic glomerulonephritis
The chronic form may develop silently (without symptoms) over several years.
Occurs when the filtration membrane becomes permanently damaged.
Early signs and symptoms of the chronic form may include:
- Blood or protein in the urine (hematuria, proteinuria)
- High blood pressure
- Swelling of your ankles or face (edema)
- Frequent nighttime urination
- Very bubbly or foamy urine
- Diminished functioning of the kidneys
- It often leads to complete kidney failure.

9. Renal calculi nephrolithiasis (nephro lith iasis) aka kidney stones
Also known as
nephrolithiasis
(nephro lith iasis)
aka kidney stones
Accumulation of crystals
of calcium phosphate,
along with uric acid and
other substances that clump
together
Slowly grow in size
Fill renal pelvis, obstruct urine
flow in the ureters
Symptoms include extreme pain, occurs
suddenly in the area of kidney and move
to groin area
May have nausea/vomiting, burning,
frequent urge to void, chills, fever,
weakness, maybe hematuria
Diagnosis by symptoms, ultrasound, x-rays
Treatment includes increase of fluids to
flush out, meds to dissolve the stone
If not resolved a urethroscope or lithotripsy
may be done

10. Renal calculi What will happen if the ureters are blocked?
Hydronephrosis – the distention of the renal pelvis and calyces due to the accumulation of fluid

11. Lithotripsy aka ESWL extracorporeal shockwave lithotripsy
Uses shockwaves created outside the body to travel thru skin and body tissue until it hits the stones causing them to break up
They can then pass out thru the urine flow
Is it a cure? No, may need to be done repeatedly.

12. Ureteroscopic stone removal

15. - Longueur : 11cm (length) - Largeur : 9cm (width)
Dimension du calcul :
- Longueur : 11cm (length)
- Largeur : 9cm (width)
- Epaisseur : 8cm (thickness)
- Poids : 2Kg (weight)
1 kilogram is equal to lb
Cambodia 2012

16. Renal failure
Acute or Chronic

17. Renal failure Acute May be sudden onset
Cause varies: nephritis, shock, injury, bleeding, sudden heart failure, or poisoning
Symptoms include: oliguria, anuria and uremia
Uremia symptoms: h/a, dyspnea, n/v, extreme cases – coma and death

18. Renal failure Chronic Gradual loss of nephron function
There may not be any symptoms for a long while
Can take months to years to occur
It may be so slow that by the time symptoms appear and are detected less than 1/10th of kidney function is happening
Final stage called End-Stage Renal Disease or ERSD

19. Renal failure Renal Failure
Chronic kidney disease leads to a buildup of fluid and waste products in the body.
How are these systems affected by renal failure?

20. Renal Failure – system symptoms
Nervous System
- drowsy, confused
- issues concentrating or thinking
- numbness hands, feet, other areas
- muscle twitching or cramps
Respiratory System
- shortness of breath
Digestive System
- weight loss without trying
- frequent hiccups
- nausea
- breath odor
- excessive thirst
- blood in stool
- vomiting, typically in the morning
Urinary System
- build up of fluid and waste
- inability to urinate
- urinalysis may reveal proteinuria
Integumentary System
- itching (pruritus)
- dry skin
- abnormally dark or light skin
- easy bruising
- easy bleeding
- edema (swelling) feet and hands

21. Diagnosis Urinalysis Creatinine clearance Creatinine levels BUN
Changes seen
in the following:
- albumin
- calcium
- cholesterol
- CBC
- electrolytes
- magnesium
- phosphorus
- potassium
- sodium
AND MORE…..
Urinalysis
Creatinine clearance
Creatinine levels
BUN

22. Renal failure Treatment option: Peritoneal dialysis
Serves as a substitute kidney
Uses the patient’s own peritoneal lining to filter the blood
Dialysate placed in abdomen via catheter
Fluid, wastes, electrolytes and chemicals pass from capillaries in the peritoneal membrane into the dialysate
After several hours drained from abdomen taking waste from blood out
Process takes about 30 minutes and done about 4 times a day
Dialysate is a cleaning solution

23. Renal failure Treatment option: Hemodialysis
Serves as a substitute kidney
Involves passage of blood thru a device that removes harmful wastes, extra salt and water
Usually done 2 to 3 times a week for 2 to 4 hours
Patients are asked to eat a special diet and take prescribed meds

24. Renal failure
Compare the treatment of acute and chronic renal failure.

25. How does hemodialysis mimic
glomerular function?

26. renal transplant What is involved in this treatment option?
- done in cases of prolonged
chronic debilitating disease
with renal failure of BOTH kidneys
- typical patient has been on dialysis
for a long period of time waiting for
a compatible organ
Two types of transplants:
- donor from a living donor (a
matching family member, usually)
- donor of unrelated person who has
died
- blood and other cellular material
must match from donor to recipient

27. Renal transplant
What is the major complication of renal transplantation?

28. Rejection… Medication must be taken everyday to prevent rejection
The maintenance agents are generally 4 classes of drugs called immunosuppressants:
- Calcineurin Inhibitors: Tacrolimus and Cyclosporine
- Antiproliferative agents: Mycophenolate Mofetil,
Mycophenolate Sodium and Azathioprine
- mTOR inhibitor: Sirolimus
- Steroids: Prednisone