This document provides an overview of renal function and renal function tests. It discusses the key functions of the kidneys including electrolyte and water balance, acid-base balance, and excretion of waste products. It describes factors that regulate renal function such as autoregulation, neural and hormonal control. Causes of renal dysfunction including acute and chronic kidney disease are outlined. Consequences of impaired renal function like retention of waste products and end organ damage are summarized. Finally, the document categorizes and describes various renal function tests including clearance tests, urine analysis, imaging studies, and renal biopsy.
Kidneys play a vital role in the excretion of waste products and toxins from blood such as urea, creatinine and uric acid and maintain the acid-base balance and the overall homeostatic mechanism of the body.-They are several clinical laboratory tests that are useful in investigating and evaluating kidney function
rft is described in detail . function of kidney, objectives of doing the test. the various test available for assessing the renal function with clinical interpretation is available.
Kidneys play a vital role in the excretion of waste products and toxins from blood such as urea, creatinine and uric acid and maintain the acid-base balance and the overall homeostatic mechanism of the body.-They are several clinical laboratory tests that are useful in investigating and evaluating kidney function
rft is described in detail . function of kidney, objectives of doing the test. the various test available for assessing the renal function with clinical interpretation is available.
Acute renal failure (ARF), characterized by sudden loss of the ability of the kidneys to excrete wastes, concentrate urine, conserve electrolytes, and maintain fluid balance, is a frequent clinical problem, particularly in the intensive care unit, where it is associated with a mortality of between 50% and 80%. In this review, the epidemiology and pathophysiology of ARF are discussed, including the vascular, tubular, and inflammatory perturbations. The clinical evaluation of ARF and implications for potential future therapies to decrease the high mortality are described.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
1. Renal function & dysfunction:
a summary
Dr. Madanmohan. MD, DSc, FIAY
Prof & Head, Dept. of Physiology
1
2. Scheme of my talk
• Functions of kidneys
• Renal function in children
• Regulation of renal function
• Causes of renal dysfunction
• Consequences of impaired renal function
• Renal function tests:
classification
description 2
11. Renal function in children
• Infants: nephrons incompletely developed
• Less BP, RBF, GFR, reabsorption, secretion
• Inulin clearance : 25%
• Urine acidic, albumin often present
• Less responsive to hormones 11
Contd…
12. Renal function in children
Urine output:
• First 2 days: 20 ml
• 12th
day : 225 ml
• ~10 y: near adult values
• Narrow margin, especially in premature
• Diarrhea, vomiting, fever, hyperthermia:
cannot concentrate urine 12
…Contd
13. Regulation of renal function
• Autoregulation
• Neural and reflex regulation:
– Rich sympathetic innervation
– Exercise, shock: vasoconstriction
• Humoral regulation
13
14. Humoral regulation
• ADH: water reabsorption
• Aldosterone: Na reabsorption in DCT
• PTH: Ca reabsorption & PO4 excretion
• Thyroxine: renotropic
• Glucocortocoids: for normal response to ADH
• PGs: modulate effect of other hormones
14
15. Causes of renal dysfunction
1. Acute renal disease : infection, ischemia
2. Chronic renal disease :
chronic glomerulonephritis,
tuberculosis, obstruction, polycystic kidney
3. Acute on chronic acute renal failure
4. Resection: 1 kidney compatible with life.
½ kidney ?
HT, DM CKD
15
16. Consequences of impaired renal function
1. Retention of waste products in blood:
H+
, K+
, urea, uric acid, creatine, creatinine
2. Abnormal constituents in urine: protein, cells, casts
3. Decreased ability to concentrate/dilute urine
4. End organ damage. Multi system dysfunction
5. Clinical features: edema/dehydration, increase BP,
anemia/polycythemia, decreased immunity 16
17. Renal failure
• Acute: H, K, urea (900 mg%).
Disturbed milieu interieur.
Death in 5–7 d.
• Chronic: loss of nephrons (>70%)
DM, HT, chronic infections,
polycystic kidney.
17
18.
19.
20.
21. Classification of RFTs
(battery of tests)
Direct measurement is difficult: clearance
Indirect estimation is simple: blood chemistry
21
22. 1. Clearance techniques.
2. Measure maximum tubular transport:
TmG, TmPAH, TmPO4
3. Assessment of functional state:
i) dilution test
ii) concentration test
iii) acidification test
22
Classification of RFTs
Contd…
26. GFR by inulin clearance
• Amount in urine = amount filtered
Uin x V = Pin x GFR
GFR = Uin x V / Pin
= 120 ml / 1.7 m2
Curea : 75 ml Ccreatinine : ~150 ml
26
27. RPF by PAH clearance
27
PAH: filtered + secreted
UPAH x V / PPAH
28. Tubular secretion (PAH)
28
Amount in urine = amount filtered + amount
secreted
Amount secreted = amount in urine - amount
filtered
UPAH X V - GFR X PPAH
30. Dilution test
• Excretion of H2O load: hourly samples
• H2O: 2% of body wt in 20 – 30 min, ~ 7 AM
(70 kg x 20 ml = 1400 ml)
• Urine at 8, 9, 10 AM
• One sample SG <1003 ( N: 1022 – 1030 )
• Within 3-6 h, all the input should come out
30
31. Concentration (Addis) test
• Dry meals for 18 h, no fluids from 8 PM to 8 AM
• SG: >1025, >700 mOsm/L
• Simple, but crude test
• Early detection of renal disease
• Contra-indications: hot weather, dehydration,
diuresis/polyurea (DM), adrenal insufficiency31
32. Acidification test
• NH3Cl : 0.1 g / kg orally
• Hourly urine samples for 8 h
• About 6 h : pH < 5.3
(normal pH : 4.3 – 8)
• > 8 pH : urinary infection
32
33. Imaging
• Plain X ray
• Ultrasonogram
• CT, MRI
• IVP
• Retrograde pyelography
• Renal arteriography (angiography)
• Radiorenogram: 125
I 131
I - hippuran 33