3. The kidneys are bilateral bean-shaped organs,
located in the posterior part of abdomen, and
they are reddish-brown in color.
The renal capsule which is called fibrous capsules
encloses the kidneys and aids to preserve them
against infection and trauma.
There are two regions in the kidneys, the first is the
cortex and the second is the medulla. Glomerulus ,
proximal and distal convoluted tubules are present in
renal cortex , while the loop of Henle and the
collecting duct are present in renal medulla as seen in
6. The principal role of kidneys is the elimination of
undesirable constituents from the blood stream by
the formation of urine and adjusting the rate and
capacity of its excretion.
The kidneys detoxify metabolic waste products
from the blood in several hundred thousand
functionally independent units called nephrons
The capacity of renal efficiency comprises :
fluid maintenance , electrolyte homeostasis
and blood pressure normalization.
7.
8. The pathophysiology includes glomerulosclerosis and tubule-
interstitial fibrosis which are common consequences that
follow a long-term reduction in renal mass. Structural, as well
as functional changes in surviving nephrons, will lead to
hypertrophy and hyper-filtration of the surviving nephrons.
This hypertrophy mediated by vaso-active molecules such as
cytokines, growth factors, and renin-angiotensin axis
mediators eventually result in intra-glomerular hypertension
that accelerated sclerosis of surviving nephrons. Raised intra-
glomerular hypertension will cause a reduction of glomerular
permeability and filtration surface area leading to a reduction
in GFR.
9.
10. Clinical signs and symptoms
Signs and symptoms of ESRD are non-specific.
Early signs of ESRD are usually characterized by
weakness, decreased appetite, and changes in urination,
as well as, hypertension, edema and pale skin .
Clinical symptoms of ESRD arise from the
accumulation of the nitrogenous and non-nitrogenous
toxic substances. Urea is the main nitrogenous toxic
substance contributes to uremic symptoms.
