Urinary System Diseases and Disorders



Urinary System Diseases and Disorders

Medical Terminology

I. Glomerulonephritis (Bright Disease)

Definition: Inflammation of the kidney glomerulus

A. May develop as part of a systemic disorder or may be idiopathic (unknown cause)

B. Most patients with ACUTE glomerulonephritis recover spontaneously

C. CHRONIC glomerulnephritis can result in hypertension, albuminuria (protein seeps through damaged glomerular walls), relan failure, and uremia (accumulation of metabolic byproducts that are normally excreted by health kidneys)

D. Chronic glomerulnephritis can be treated with drugs to control inflammation but dialysis or transplant may be necessary if uremia occurs

II. Nephrolithiasis

Definition: Kidney stones a.k.a. renal calculi

A. Usually composed of uric acid or calcium salts

B. Etiology is often unknown but is thought to be associated with conditions associated with an increase in concentration of calcium (parathyroid gland tumors) or high levels of uric acid in the blood (hyperuricemia which is associated with gouty arthritis)

C. Stones become lodged in ureter or bladder as well as in renal pelvis

D. May require lithotripsy ( extracorporeal, or coming from outside the body, shock waves used to crush stones) or surgery

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III. Polycystic Kidney Disease (PKD)

Definition: Multiple fluid-filled sacs (cysts) within and upon the kidney

A. Hereditary condition that usually remains asymptomatic until adult life

B. Cysts progressively develop in both kidneys leading to nephromegaly, hematuria, urinary tract infection, hypertension, and uremia

C. Polycystic kidneys can weigh as much as 38 pounds each and grow to size of football or larger; Clenched fist is size of normal kidney

D. More than ½ of people with PKD will develop kidney failure; Dialysis and transplantation are only RX.s but does not cure PKD

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IV. Pyelonephritis

Definition: Inflammation of renal pelvis and renal medulla

A. Caused by bacterial infection

B. In ACUTE pyelonephritis many small abscesses form in renal pelvis and medulla resulting in pyuria

C. Treated with antibiotics and surgical correction of any obstruction to urine flow

D. CHRONIC pyelonephritis can lead to destruction of renal tissue and to scar formation

V. Renal Cell Carcinoma

Definition: Cancerous tumor of the kidney in adulthood

A. Primary Sx is hematuria

B. Tumor often metastasizes to bones and lungs

C. Likelihood of survival depends on extent of spread of tumor

D. Rx – nephrectomy

[pic]

This is a much more advanced renal cell carcinoma involving the left kidney (top). Notice a huge mass of necrotic yellowish brown material replacing the lower pole of the kidney. Also notice that the vena cava in the center of the picture is filled with tumor. This is typical of this neoplasm.

VI. Renal Failure

Kidneys fail to excrete urine

A. Kidneys stop excreting nitrogenous waste products and acids from diet and body metabolism

B. Can be:

1. Acute or chronic

2. Reversible or progressive

3. Mild or severe

C. End-stage renal disease (ESRD) is final phase of chronic renal failure; is fatal if not treated; Rx is Erythropoietin (hormone) which increases red blood cells and results in marked improvement in energy levels

D. Renal failure Rx.s include dialysis and transplants

VII. Renal Hypertension

Definition: High blood pressure resulting from kidney disease

A. Most common type of secondary hypertension which is high blood pressure caused by an abnormal condition such as glomerulonephritis or renal artery stenosis

B. Essential hypertension is when the cause of high blood pressure is not known

C. CHRONIC ESSENTIAL HYPERTENSION can cause arteriole walls in kidney to become narrowed and thickened a.k.a. nephrosclerosis resulting in glomerular ischemia, atrophy, and scarring of kidney tissue

VIII. Bladder Cancer

Definition: Malignant tumor of the urinary bladder

A. Most common site of malignancy in urinary system

B. More common in men (often smokers) and in person over 50, especially in industrial workers exposed to dyes and leather

C. Sx.s – hematuria, dysuria, and increased urinary frequency

D. Staging of tumor is based on depth it has penetrated bladder wall and extent of metastasis

E. Superficial tumors are removed by electrocauterization

F. More invasive tumors require cystectomy, chemotherapy, and radiation therapy

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IX. Diabetes Insipidus

Definition: Inadequate secretion or resistance of the kidney to the action of antidiuretic hormone (ADH)

A. Lack of ADH prevents water from being reabsorbed into the blood through the renal tubules; inability of kidney to hold urine in the body

B. Two major Sx.s are polydipsia and polyuria

X. Diabetes Mellitus

Definition: Inadequate secretion or improper utilization of insulin

A. Sugar is prevented from leaving the bloodstream and cannot be used by body cells for energy; therefore, sugar remains in the blood and spills over into the urine when the kidney cannot reabsorb it through the renal tubules

B. Major Sx.s are glycosuria, hyperglycemia, polyuria, and polydipsia

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