Flow Interference anywhere along Urinary Tract
↑ Infection Risk + ↓ Renal Functions (↓ GFR)
Dilation of Distal Structures (ex. Hydronephrosis)
Excessive Fibrosis & Apoptosis → Kidney Damages
3-4 Weeks → Irreversible Damages & Loss of Function
Unilateral Obstruction → Compensatory Hypertrophy
Post obstructive Diuresis → Fluid/Electrolyte Imbalance
upper UTO
Dilation of Ureter & Pelvicalyceal system
Ureterohydronephrosis:
Dilation of Renal Pelvis & Calyces
Hydronephrosis:
cause of UTO
most common composition : Calcium + Phosphate
↑ Risk of Chronic Kidney Disease & Myocardial Infarcts
Renal Colic = Moderate to Severe Pain
Often incapacitating + Nausea and Vomiting
Obstructions:
Posterior Flank Colic → Pelvis or Proximal Ureter
Lateral Flank Colic → Midureter
Urgency/Urge Incontinence → Lower Ureter
kidney stones
decrease coordination between bladder and sphincter
dyssynergia
automatic bladder emptying when full
hyperreflexia
Automatic bladder emptying with sphincter contraction → Functional obstruction
lesion between S1 and C2
Overactive Bladder Syndrome
Urine retention → Bladder distention
lesion below S1
Underactive Bladder Syndrome
what are the manifestation of urine flow obstruction?
frequent voiding
nocturia, urgency and dysuria
weak and intermittent stream
feeling of full bladder despite urination.
what bacteria are involved in acute cytitis?
E.coli and Staphylococcus S.
what are the manifestation of acute cytitis?
common: Frequency + Urgency + Dysuria; Low Back Pain
Severe: Hematuria; Flank Pain; Foul-Smelling urine
Renal Edema & Inflammation Purulent (WBC) Urine Medullary Abscesses Classic UTI Sx (Frequency, Dysuria, etc) Acute Systemic Sx (Fever & Flank Pain)
Acute Pyelonephritis
Tubule & Pelvis Atrophy + Dilation
↓
Permanent Kidney Scarring
Chronic pyelonephritis
Classic Sx → Hematuria & Proteinuria (by increased permeability)
Severe Cases: Edema + Hypertension + ↓ Renal Functions (by a decrease in GFR)
Acute Glomerulonephritis
Chronic Hyperglycemia
↓
Metabolic + Microvascular + Inflammatory Damages
↓
Glomerular Membrane Fibrosis + Mesangial Proliferation
↓
Proteinuria & Chronic Kidney Disease
Diabetic nephropathy
Complication of SLE → Autoimmune Complexes Deposition
↓
Complement Activation + Inflammatory Cascade
↓
Glomerular Membrane Fibrosis + Mesangial Proliferation
Lupus Nephritis
Altered glomerular permeability and loss of negative change - protenuria
manifestations : edema and lipiduria
Protein Excretion ˃ 3g/day + Hypoalbuminemia + Edema
Cause = Glomerular Injuries
Nephrotic Syndrome
Hematuria (RBC Casts) with mild Proteinuria
Cause = Glomerular Pores ˃ RBC
Nephritic Syndrome
Chronic kidney diseas is associated with what systemic diseases?
Metabolic Syndrome; Diabetes; SLE; AKI or Chronic Glomerulonephritis
↑ Angiotensin II: ↑ GFR & Permeability + Systemic HT
Proteinuria: ↑ Inflammation & Progressive Fibrosis
chronic kidney injury
increases when GFR decreases
urea
symptoms of hyponatremia
Vomiting; Diarrhea; ↑ Secretions & Filtration
symptoms of hypernatremia
Excesssive Retention → HT + Edema + Heart Failure
Which of the following is the least likely to lead to Urinary Tract Obstruction? Prostate Cancer Urethral Sphincter Atrophy Pregnancy Urethral Stenosis
Urethral Sphincter Atrophy
What is the ultimate consequence of most acute kidney injuries (AKI) No urine formation Increased GFR Acute Tubular Necrosis Low urine output
Low urine output