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kerri's part 2 biomed slides > Urinary System > Flashcards

Urinary System Flashcards

1
Q

List FOUR functions of the urinary system.

A

(1) Excretion
Waste - uric acid, creatinine, urea
Ions - na, k, h
Toxins

(2) Balance

Balance in terms of what to retain and what to get rid of. Specific examples are
- balance of PH levels in body fluids, especially blood
- glucose
- electrolytes/ water balance

(3) Production of hormones – Erythropoietin and Calcitriol

(4) Regulation of blood pressure, volume and osmolarity (concentration)

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2
Q

Name three types of waste products excreted by the kidney

A

(1) Metabolic wastes which include Urea, Uric Acid and Creatinine

(2) Ions such as H+

(3) Toxins which include those ingested, absorbed, inhaled, medications, deactivated hormones.

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3
Q

Name THREE metabolic wastes containing nitrogen excreted by the urinary system.

A

Urea
Uric Acid
Creatinine

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4
Q

Name ONE ion excreted by the urinary system.

A

Hydrogen

This is particularly important to prevent excess acidity

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5
Q

State the minimum daily quantity of urine (ml) required to clear body waste.

A

500 ml

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6
Q

Name THREE electrolytes regulated by the kidneys

A

Sodium
Potassium
Hydrogen
Chloride
Bicarbonate

Magnesium (I think)

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7
Q

Describe specifically how the kidney plays a role in blood pH balance

A
  1. The kidney excretes Hydrogen into urine.
  2. They also produce the buffer bicarbonate (HCO3) to neutralise acidity
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8
Q

Describe the main role of the following hormones in relation to the kidney:

a. Calcitriol

b. Erythropoietin

A

a. Calcitriol

  • active form of Vit D
  • Stimulates calcium and magnesium uptake from the GIT. These are key minerals needed for bone strength and muscle contraction and release.
  • Reduces calcium loss from the kidneys so that blood calcium levels go up.

b. Erythropoietin

  • It triggers red bone marrow to manufacture red blood cells. (Erythropoiesis
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9
Q

Explain why anaemia is common in renal failure

A

In renal failure, erythropoietin production is inadequate leading to a lack of production of red blood cells and resulting in anaemia

Also losing blood cells through glomerula damage

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10
Q

State the normal renal threshold for glucose in mmol / L.

A

Normal range 4-7 mmol

The renal threshold is 9 mmol/L, after which it is excreted

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11
Q

Describe specifically how the kidney compensates for ‘low blood glucose’

A

The kidneys are able to make glucose by converting the amino acid glutamine to help elevate blood sugar levels when they are low. It is called gluconeogenesis.

Glutamine is highly circulating in our blood.

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12
Q

Explain why the right kidney is lower that the left kidney.

A

The liver occupies considerable space on the right side

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13
Q

With regards to renal anatomy of the following tissue layers, describe where they are located and what their functions is.

Tissue Layers
1. Renal Capsule
2. Adipose Capsule
3. Renal Fascia

A

Tissue layer name: Renal Capsule
Tissue layer location: Deep layer
Tissue layer function: Connective tissue; maintains kidney shape

Tissue layer name: Adipose Capsule
Tissue layer location: Middle layer
Tissue layer function: Fatty tissue layer; Protection and support

Tissue layer name: Renal Fascia
Tissue layer location: Superficial layer
Tissue layer function: Connective tissue; anchors the kidney

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14
Q

The kidney is divided into two distinct regions. What are they?

A

The renal cortex,
and the renal medulla.

The renal cortex houses the renal corpuscle and convoluted tubules

The renal medulla houses the renal pyramids and loop of Henle.

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15
Q

Explain what is meant by the ‘hilum’.

A

It is the point of entry and exit to the kidneys for blood vessels, lymph vessels, nerves and ureters

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16
Q

State the % cardiac output received by the kidney.

A

20-25% of cardiac output goes through the kidneys

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17
Q

Name the location into which urine drains from the nephrons

A

The minor and major calyces

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18
Q

State which of the following components are in the ‘renal tubule’ or ‘renal corpuscle’:

a. Loop of Henle

b. Distal convoluted tubule

c. Proximal convoluted tubule

d. Bowman’s capsule

e. Glomerulus

A

a. Loop of Henle –Renal Tubule

b. Distal convoluted tubule – Renal Tubule

c. Proximal convoluted tubule – Renal Tubule

d. Bowman’s capsule – Renal Corpuscle

e. Glomerulus – Renal Corpuscle

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19
Q

Draw and label the ‘nephron’:

A
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20
Q

Name the specific location in a nephron where anti-diuretic hormone acts

A

The distal convoluted tubule in order to reabsorb water

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21
Q

Which part of the nephron reabsorbs the most water?

A

Proximal Convoluted Tubule

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22
Q

Explain how urine is transported from the renal pelvis to the urinary bladder.

A

It is transported through two ureters, each 25-30 cm long. Peristaltic contractions, the pressure of the urine and gravity move the urine along.

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23
Q

Describe the three layers of the ureters and their role.

A

Inner mucous membrane - contains transitional epithelium which is able to stretch and goblet cells to secrete mucus

Muscularis – Middle layer of smooth muscle fibres produce peristaltic contractions to move urine through the ureter.

Adventitia – Outer coat of connective tissue containing blood and lymph vessels and nerves of the ‘muscularis’ in the ureter.

*NOTE: The urinary bladder has a very similar 3 layers but the smooth muscle in the muscularis layer is called Detrusor muscle

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24
Q

State the volume of urine (ml) which when exceeded triggers a desire to urinate.

A

200 ml

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25
Q

Name the small triangular area located on the posterior floor of the bladder.

A

Trigone - It is a flat section at the bottom of the bladder that is bordered by the two ureteral openings and the urethral opening.

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26
Q

Name the specific location of the ‘detrusor muscle’

A

Muscularis layer of the bladder
It is used to create the internal urethral sphincter.

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27
Q

Explain the difference between the ‘internal urethral’ and ‘external urethral’ sphincters in the urethra.

A

The internal urethral sphincter is made of smooth muscle and is involuntary.
The external urethral sphincter is voluntary

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28
Q

List TWO differences between the female and male urethras.

A
  • Length: 4 cm verses 20 cm for women verses men as for me it needs to go through the penis.
  • Male urethra passes through the prostrate
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29
Q

Name THREE processes involved in urine formation

A
  1. Glomerular Filtration
  2. Tubular Reabsorption
  3. Tubular Secretion
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30
Q

Describe specifically how the glomerulus is adapted for filtration.

A
  • It has a large surface area for filtration.
  • It is very leaky, 50 x more than normal capillaries, which allows substances to be pushed through easily
  • Efferent arteriole is much narrower than the afferent arteriole which means that substances get in more easily than they get out allowing more time in the glomerulus for filtration.
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31
Q

Name FOUR blood constituents that pass into glomerular filtrate.

A
  1. Amino acids
  2. Electrolytes (mineral salts)
  3. Glucose
  4. Hormones
  5. Toxins
  6. Waste products – urea; uric acid; creatinine
  7. Water
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32
Q

Name TWO blood constituents that remain in glomerular capillaries.

A

Plasma Proteins
Blood cells – red, white and platelets

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33
Q

Define glomerular filtration rate (GFR). Why do we use it?

A

The amount of filtrate formed in the renal corpuscles of both kidneys each minute.

It is a measure of kidney disease. Anything affecting the Glomerular Filtration process will affect the GFR.

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34
Q

State how GFR is measured.

A

Through a blood test

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35
Q

State the normal adult GFR range

A
  • should be > than 90.
  • Typically it is higher in men at 125ml/min and for women 105 ml/min
  • 15ml/min suggests kidney failure

What does GFR stand for?
Global filtration rate

Through what intervention is GFR measured?
Blood test

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36
Q

Describe specifically how ‘colloid osmotic pressure’ develops

A

Colloid Osmotic Pressure is a pressure exerted by proteins, most notably albumin.

Albumin helps to retain water by attracting it.

Albumin should not pass through the glomerulus. When it does it is excreted with urine and you will see a frothy urine.

Less albumin in the blood lowers osmotic pressure and this means that the blood is less able to retain water. This leads to accumulation of interstitial fluid causing oedema.

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37
Q

Name THREE substances / molecules which are:

a. Reabsorbed via tubular reabsorption

b. Secreted into tubular fluid

A

a. Reabsorbed via tubular reabsorption
1. Water
2. Amino acids and glucose
3. Electrolytes

b. Secreted into tubular fluid
1. Waste products – urea, ammonium ions, creatinine
2. Some drugs eg: penicillin
3. Excess ions such as H= for PH regulation

38
Q

Describe in detail how the ‘RAAS (renin-angiotensin-aldosterone-system)’ works to increase blood pressure.

A

If systolic blood pressure is low

Kidneys release Enzyme Renin into the blood

Liver uses the Enzyme Renin to convert inactive Angiotensinogen to the hormone Angiotensin I

Lungs convert Angiotensin I to Angiotensin II using an enzyme called ACE (Angiotensin-Converting-enzyme)

so, now we have Angiotensin2 three thingshappens next.

  1. Adrenal Cortex stimulated by Angiotensin II to release of Aldosterone

Aldosterone stimulates sodium and water absorption in the kidneys, increasing blood volume and blood pressure.

  1. Angiotensin 2 also act directly on blood vessels to stimulate vasoconstriction.
  2. Pituitary gland triggered by Angiotensin II to release anti-diuretic hormone (ADH) acting on the distal convoluted tubule to transport water thus raising water and pressure in blood vessels
39
Q

How does Aldosterone and Angiotensin II have an effect on blood pressure?

A
  • Aldosterone acts on the kidneys to stimulate the absorption of salt and water which increases blood pressure.
  • Angiotensin II is a vasoconstrictor which increases blood pressure
40
Q

Describe the role of the angiotensin-converting enzyme (ACE).

A

ACE converts Angiotensin I into Angiotensin II

41
Q

Identify where ACE is released in the body.

A

Lungs

42
Q

Describe how Angiotensin II is a vasoconstrictor which increases blood pressure. It acts upon the:

a. Pituitary gland

b. Blood vessels

C. Adrenal cortex

A

Angiotensin 2 triggers vasoconstriction which subsequently increases blood pressure.

a. Pituitary gland
Triggers the pituitary gland to release anti-diuretic hormone (ADH) thus raising water and pressure in blood vessels

b. Blood vessels
Triggers vasoconstriction to increase blood pressure

C. Stimulates the adrenal cortex to produce Aldesterone which increases, renal sodium and water absorption.

43
Q

Explain how aldosterone affects sodium and water reabsorption

A

Aldosterone increases renal sodium which leads to water reabsorption. Water is attracted to salt.

44
Q

List ONE trigger for anti-diuretic hormone (ADH)

A
  • Low blood pressure.

Reduced water concentration and lowered blood volume increase blood osmotic pressure

45
Q

Explain how ADH can rebalance osmotic pressure

A

ADH increases the permeability of the distal convoluted tubules, thus increasing reabsorption in the kidneys.

In short, it prevents the kidneys from releasing urine and thereby eliminating water from the body. More water, lower osmotic pressure.

46
Q

Describe the role of the atrial natriuretic peptide (ANP)

A

The role of ANP is to reduce blood pressure so it is dealing with high blood pressure.

ANP is triggered by atrial stretch in the atrium cause by an increase in blood volume. It has the opposite role to ADH and aldosterone which deal with low blood pressure.

ANP inhibits reabsorption of Na+ (sodium) and water in the renal tubes.

It also inhibits ADH and aldosterone

These effects increase urine output and reduce blood volume .. hence lower blood pressure

47
Q

What is the role of parathyroid hormones in the urinary system?

A

Increase blood calcium levels

  1. It works on the kidneys telling them to re-absorb calcium and magnesium
  2. It works on the kidneys, telling them to release calcitriol to increase gut calcium absorption.
  3. It increases osteoclastic activity to breakdown bone matrix.
48
Q

Define micturition

A

The discharge of urine from the bladder.

When the volume in the bladder exceeds 200-400m stretch receptors in the bladder wall transmit nerve impulses to the spinal chord at S2 and S3

49
Q

Name the levels of the spinal cord which involve the micturition reflex.

A

S2 and S3

50
Q

Describe the difference between micturition in infants and in adults.

A

In infants, stretch receptors in the bladder wall transmit a nerve impulse that generates a micturition reflex leading to contraction of the detrusor muscle and relaxation of both of the internal and external urethral sphincters.

In adults, the nervous system has matured adequately, so we still get the reflex response to generate a micturition response but we voluntarily override it.

51
Q

List FOUR signs / symptoms which may indicate a urinary tract pathology.

A

URINE signs
1. Dysuria + Frequent with urgency
2. Haematuria Red urine**
3. Oliguria Low or no urine volume
4. Pain in the loin (lower back) and worse with urination

SYSTEMIC symptoms
5. Oedema
6. Nausea, and vomiting.
7. Exhaustion

52
Q

List FOUR signs / symptoms which may indicate possible renal disease and explain why they occur:

A
  1. Pallor: due to Anaemia

Loss of proteins
2. Frothy urine: Due to leaking of proteins
3. Oedema: Due to protein loss (albumin in particular)
4. Oedematis: puffy, face bags, under the eyes,

Toxin build up
5. Itchy skin: Uraemia.
6. altered mental state
7. Flapping tremor
dehydration

53
Q

Explain why renal disease can cause oedema

A

With renal disease, plasma proteins such as Albumin which are involved in maintaining osmotic pressure in the cells can be lost in the urine. If they are lacking, fluid rather than being pulled into the blood by albumin, leaks out into the cell tissues and builds up creating swelling.

54
Q

Identify ONE pathology for each of the following urinalysis parameters:

a. Protein

b. Bacteria

c. Glucose

d. Casts

A

a. Protein – Very strong indication of kidney disease because there is not other way for proteins to get into the urine. Normally they are too big to pass through the glomerulus suggesting it is damaged.

b. Bacteria - UTI

c. Glucose – Diabetes Melitus

d. Casts –
Urinary casts are clumps of material formed in nephrons. It normally comprises red and white blood cells, proteins and bacteria. When they clump together it suggests disease of the nephron or kidney.

55
Q

Define the following urinary terminology:

Polyuria
Anuria
Dysuria
Proteinuria
Haematuria
Oliguria
Nocturia
Bacteriauria
Glucosuria

A

Polyuria - Large quantity of urine
Anura’s - No urine
Dysuria - Painful burning urination
Proteinuria - Protein in urine
Haematuria - Blood in urine
Oliguria (<400mL/day) - Little urine
Nocturia - Night urination
Bacteriauria - Bacteria in urine
Glucosuria - Sugar in urine

56
Q

Is urine normally slightly acidic or alkaline?

A

Slightly acidic

57
Q

Explain why cystitis is more common in women.

A

The urethra is only 4 cm long as opposed to 20 cm in men which makes the path for bacteria into the urinary tract much easier than for men. Anus is closer to the urethra and easier access for bacteria when wiping.

58
Q

Name the main cause of cystitis.

A

In 75% of cases it is an E.coli bacterial caused by:

  • Bacteria being pushed into the urethra through backward wiping, catheterisation, very sexually active
  • Post menopausal due to thinned lining
  • Diabetes Mellitus - rich sugar diet sits in the bladder with E.coli
59
Q

List THREE signs / symptoms of cystitis.

A
  • Pain in lower back and abdomen
  • Dysuria and urgent need to urinate but only pass small amounts
  • Systemic signs: Fever, malaise, nausea
  • Dark, smelly/cloudy urine
60
Q

With regards to the diagnosis of cystitis, describe what the following tests should reveal:

Dipstick test:

Urine microscopy:

A

Dipstick test: Test for nitrites, leukocytes and erythrocytes

Note: If there are nitrites in urine it is a very strong indication of a bacterial infection such as cystisis or a UTI. However the absence of nitrites does not mean an infection is not there as it is not a very sensitive test and therefore in 75% of cases where there is an infection the dipstick test will not iondicate nitrates..

Urine microscopy: Significant bacteriuria

61
Q

Using definitions, compare ‘pyelonephritis and ‘cystitis’.

A

Cystitis is a type of UTI. It is an infection of the bladder. In 75% of cases it is caused by the E.Coli bacteria.

Pyelonephritis: an infection of the kidney also can be cause by E. coli spreading from the bladder

IWhen chronic it can lead to tissue scaring which affects kidney function

Signs and symptoms of cystitis VS pylonephritis

Both:
- Dysuria and increased frequency/urgency
- foul smelling and cloudy urine
- both have systemic symptoms such as fever, malaise, and nausea

Pain:
Cystitis - Pain in the lower back and abdomen
Pyelonephritis - loin pain and and tenderness which is often unilateral.

Heamaturia:
Pylonephtitis only

62
Q

Name TWO signs / symptoms more suggestive of pyelonephritis.

A

Pyelonephritis is a kidney infection.

Loin pain and tenderness that is often unilateral.
Haematuria - blood in urine

Otherwise the signs and symptoms are similar to cystisis
* Dysuria and increased frequency and urgency
* Systemic signs of infection – malaise, nausea, fever
* cloudy and smelly urine

63
Q

Name TWO causes (not infection) of pyelonephritis.

A

Pyelonephritis is a kidney infection. Apart from infection spreading from the bladder…

  • Diabetes Mellitus – build of sugars in the kidney allow bacteria to colonise
  • Immunocompromised patients – Bacteria has quite a distance to travel (30cm) which gives the immune system time to operate ordinarily
  • Obstructed flow of urine due to enlarged prostrate or kidney stones
  • Pregnancy
  • Gout – uric acid acculumates in the kidneys
64
Q

Explain how pyelonephritis can lead to scarring of renal tissue

A

Destruction of kidney cells (necrosis) leads to scarring

65
Q

With regards to the diagnosis of pyelonephritis, describe what the following tests should reveal:

a. Dipstick test

b. Urine microscopy

c. Blood test

A

a. Dipstick test
- PROTEIN - this is what differentiates it diagnostically from UTI’s. As soon as you see proteins you know the problem is coming from the kidney
- Nitrites suggesting infection but not sensitive so absence does not mean you don’t have an infection
- Erythrocytes – Indicate blood on urine
- Leukocytes - indicate UTI

b. Urine microscopy
- Bacteria - e-coli possibly
- Urinary casts suggestive of disease in the nephrons
- Blood cells
- protein

c. Blood test
- Inflammatory markets – ESR and CRP indicates infection.
- Luekoctes – indicates infection

66
Q

What is glomerulonephritis?

A

An immune mediated disease that causes glomerular inflammation

67
Q

Describe specifically the pathophysiology of glomerulonephritis

A
  1. An autoimmune reaction creates antigen, antibody, immune complexes in response to a perceived pathogen.
  2. These immune complexes are deposited in the glomeruls where they trigger an immune response and thus inflammation arises
  3. The glomerulus is already fragile, very leaky and single layered so inflammation will lead to damage.

(3) The result is that substances can get into the bowmans capsule very easily. Red Blood cells and proteins therefore leak into the urine

68
Q

List ONE secondary cause of glomerulonephritis

A

If it is secondary it means glomerula involvement is part of a systemic disease.

For example SLE otherwise known as lupus

69
Q

Name ONE trigger of an autoimmune reaction in glomerulonephritis

A

After a bacterial infection often from the upper respiratory tract and often one to three weeks after the infection occurs.

In children post streptococcal glomerulonephritis is common. They have some kind of throat infection and then within a couple of weeks they start to develop this immune response against their own glomerulus.

70
Q

Describe how hypertension can develop in glomerulonephritis

A

In Glomerulonephritis you can get scarring and fibrosis of the glomerular capillaries which reduces renal blood flow and GFR resulting in an increase in renin.

In other words when we have lots of inflammation and it keeps happening we also gets scar tissue - known as glomerulosclerosis. Kidneys try to respond to damage by increasing blood pressure through which they can cause even more damage.

71
Q

Explain why back pain is present in glomerulonephritis

A

It is due to glomerula inflammation

72
Q

Name TWO urinalysis parameters that you would expect to find in glomerulonephritis.

A

Both of these would not normally get through the glomerula unless it was damaged.
* Erythrocytes
* Protein

73
Q

Describe how oedema develops in nephrotic syndrome

A

Nephrotic syndrome is a collection of signs and symptoms associated with increased glomerular permeability and heavy proteinuria.

We have damage to the very sensitive leaky glomerulus… That leads to albumin leaking … less albumin in the blood lowers osmotic pressure … that means that water will go out of the blood and into the tissues… leading to oedema

74
Q

List TWO infectious causes of nephrotic syndrome.

A

Nephrotic syndrome is a collection of symptoms due to kidney damage.

HIV, Malaria, hepatitis

Other causes are glomerulonephritis, Lupus, Drugs (NSAIDS)

75
Q

List ONE common medicine that can cause nephrotic syndrom

A

NSAIDS

76
Q

Describe the pathophysiology of diabetic nephropathy

A
  1. Diabetes mellitus elevates blood pressure
  2. High blood pressure damages the glomerulus… scarring occurs…
  3. more blood pressure because it is not filtering the blood properly into the kidneys
  4. The kidneys try to mitigate this by releasing renin to increase blood pressure - RAAS leads to
  5. nephrotic syndrome.
77
Q

Name ONE mineral that is commonly implicated in renal calculi

A

Calcium Oxolate
Calcium Phosphate

78
Q

Explain how the position of kidney stones affects signs and symptoms experienced.

A

Kidney stones
- can stay in position where they obstruct urine outflow,or
- migrate down the urinary tract leading to severe loin pain radiating to the groin. It is known as ureteric colic

79
Q

List TWO causes of renal calculi

A

Dehydration
Gout
Hypercalcaemia – high calcium levels in the blood

80
Q

Describe the pain associated with renal calculi

A

It is often asymptomatic or you can experience severe loin pain.

However when the kidney stones migrate down the ureter you feel this pain in the groin and it is a sign that they are being passed

81
Q

Describe the key difference between ‘haemodialysis’ and ‘peritoneal dialyses.

A

Dialysis is used for patients in renal failure. It mimics excretory function of kidneys to remove waste and balance electrolytes

Haemodialysis remove waste products and water from the blood. Usually in hospital.

Peritoneal dialyses removes waster via a tube in the peritoneal cavity between the visceral and parietal layers. Can be done at home. Risk or peritonitis.

82
Q

Label the parts of the kidney

A
83
Q

What is the difference between Pyelonephritis and Glomerulonephritis

A

Pyelonephritis and Glomerulonephritis can both cause damage to the kidneys and affect their function.

Pyelonephritis is an infection of the upper urinary tract that affects the kidneys and the ureters. It is usually caused by bacteria that enter the urinary tract from the urethra or bladder and then spread to the kidneys. Pyelonephritis can be acute or chronic, and it can cause serious complications if left untreate.

Glomerulonephritis is an inflammation of the glomeruli, which are tiny filters in the kidneys that remove waste and excess fluid from the blood. It is caused by an immune response that damages the glomeruli and impairs their function. Glomerulonephritis can be acute or chronic, and it can lead to kidney failure if not treated properly.

84
Q

Explain why anaemia is more likely in a patient with kidney failure

A

The kidneys produce the hormone erythropoietin which stimulates erythropoiesis so if the kidneys are not functioning well red blood cell production will be affected.

85
Q

What are the five stages of kidney disease based on the GFR?

A

< 90 – Chronic Kidney Disease (CKD) stage one
60 to 89 – CKD stage two
30 to 59 - CKD stage 3
15 to 29 - CKD stage 4
< 15 - CKD stage 5

86
Q

What does a diuretic do?

A

Reduce water and sodium reabsorption from the kidney tubes.

Used for oedema and to increase blood pressure

they can cause, excessive excretion of potassium, sodium, chloride and magnesium so it is essential to replace lost electrolytes

87
Q

Label this diagram of the kidney

A
88
Q

What are the two parts of the kidney and where does the nephron fit within this?

A

The kidney is divided into the renal cortex and the renal medulla.

The renal corpus le (comprising the glomerulus and the Bowman capsule), and both convoluted tubules lie in the renal cortex.

The loop of Henle often extends into the renal medulla
It is the first part of the nephron, and it consists of the glomerulus and the Bowman capsule.

89
Q

What is the difference between ADH and aldosterone mechanisms?

A

In both cases, they are working to increase blood pressure, and in both cases they are doing this through the kidneys but they are doing it through different mechanisms.

ADH does it by withholding the release of water
Aldosterone does it by increasing renal sodium and water reabsorption

90
Q

Urine analysis can be divided into dipstick analysis and microscopy. They generally assess different things.

A

Leukocytes and erythrocytes are tested in both
PH untested in both

Dipstick
- ketones
- Nitrites (suggest, but doesn’t prove infection)
- Uribilinogen (from Bilirubin)

microscopy
- volume/colour/odour
- casts (clumps of material formed in nephron that normally include red blood cells, white blood cells, proteins and bacteria, and basically say that we have some kind of disease process in progress)
- Bacteria

91
Q

Making sense of the pathologies for this unit

A

Infections
* Cystitis is an infection of the bladder
* Pyelonephritis is an infection of the kidney

Glomerular issue
* Glomerulonephritis is an autoimmune disease that damages the glomerulus
* Nephrotic syndrome causes glomerular permeability
* Diabetic kidney (neuropathy)

Other
* renal calculi

kerri's part 2 biomed slides (8 decks)

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