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A review:   RENAL PHYSIOLOGY ,[object Object]
Structure of the kidney ,[object Object],[object Object],[object Object],[object Object]
Nephrons ,[object Object],[object Object],[object Object],[object Object]
Urine formation:
Renal physiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contribution of different nephron segments to solute and water hemostasis (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contribution of different nephron segments to solute and water hemostasis (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contribution of different nephron segments to solute and water hemostasis (3) ,[object Object],[object Object],[object Object],[object Object]
Contribution of different nephron segments to solute and water hemostasis (4) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANTIDIURETIC HORMONE REGULATION MECHANISMS ↓ Blood volume or ↓BP Volume receptor Atria and great veins Hypothalamus ↓ Posterior pituitary gland Osmoreceptors in hypothalamus ↑ Osmolarity ↑ ADH Kidney tubules ↑ H2O reabsorption ↑ vascular volume and ↓osmolarity Narcotics, Stress, Anesthetic agents, Heat, Nicotine, Antineoplastic agents, Surgery
ALDOSTERONE-RENIN-ANGIOTENSIN SYSTEM Angiotensinogen in plasma Juxtaglomerular cells-kidney ↓ Serum Sodium ↓Blood volume Angiotensin I Kidney tubules Angiotensin II Adrenal Cortex ↑ Sodium resorption (H2O resorbed with sodium); ↑ Blood volume RENIN Angiotensin-converting enzyme ALDOSTERONE Intestine, sweat glands, Salivary glands Via vasoconstriction of arterial smooth muscle
REGULATION OF BODY COMPONENTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
 
RENAL FAILURE Ma. Tosca Cybil A. Torres, RN
RENAL FAILURE ,[object Object],[object Object]
ACUTE RENAL FAILURE  ,[object Object],[object Object]
Categories of Acute Renal Failure ,[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
 
Comparing Categories of Acute Renal Failure  Characteristics Categories Prerenal Intrarenal Postrenal Etiology Hypoperfusion Parenchymal damage Obstruction BUN value Increased  Increased increased Creatinine Increased Increased Increased Urine output Decreased Varies, often decreased Varies, may be decreased, or sudden anuria Urine sodium Decreased to < 20 mEq/L Increased to >40mEq/L Varies, often decreased to 20mEq/L or less Urinary sediment Normal, few hyaline casts Abnormal casts and debris Usually normal Urine osmolality Increased to 500mOsm About 350 mOsm similar to serum Varies, increased or equal to serum Urine specific gravity Increased Low normal Varies
Causes of Acute Renal Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Acute Renal Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of Acute Renal Failure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Phases of ARF ,[object Object],[object Object],[object Object],[object Object]
Preventing ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preventing ARF ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Management: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Management ,[object Object],[object Object],[object Object]
Nursing Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHRONIC RENAL FAILURE/END STAGE RENAL DISEASE (ESRD) ,[object Object]
ESRD ,[object Object],[object Object],[object Object]
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment and Diagnostic Findings ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DIALYSIS ,[object Object],[object Object],[object Object],[object Object]
DIALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
PERITONEAL DIALYSIS ,[object Object],[object Object],[object Object],[object Object]
PERITONEAL DIALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Peritoneal Dialysis ,[object Object],[object Object]
Pre and post operative care for Tenckhoff catheter insertion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre and post operative care for Tenckhoff catheter insertion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PERITONEAL DIALYSIS
PERITONEAL DIALYSIS
PERITONEAL DIALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEMODIALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEMODIALYSIS
HEMODIALYSIS Patient Access Vascular catheter  A-V fistula  Synthetic vascular graft
HEMODIALYSIS
HEMODIALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KIDNEY TRANSPLANT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KIDNEY TRANSPLANT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]

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Renal Failure

  • 1.
  • 2.
  • 3.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. ANTIDIURETIC HORMONE REGULATION MECHANISMS ↓ Blood volume or ↓BP Volume receptor Atria and great veins Hypothalamus ↓ Posterior pituitary gland Osmoreceptors in hypothalamus ↑ Osmolarity ↑ ADH Kidney tubules ↑ H2O reabsorption ↑ vascular volume and ↓osmolarity Narcotics, Stress, Anesthetic agents, Heat, Nicotine, Antineoplastic agents, Surgery
  • 11. ALDOSTERONE-RENIN-ANGIOTENSIN SYSTEM Angiotensinogen in plasma Juxtaglomerular cells-kidney ↓ Serum Sodium ↓Blood volume Angiotensin I Kidney tubules Angiotensin II Adrenal Cortex ↑ Sodium resorption (H2O resorbed with sodium); ↑ Blood volume RENIN Angiotensin-converting enzyme ALDOSTERONE Intestine, sweat glands, Salivary glands Via vasoconstriction of arterial smooth muscle
  • 12.
  • 13.
  • 14.  
  • 15. RENAL FAILURE Ma. Tosca Cybil A. Torres, RN
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.  
  • 22. Comparing Categories of Acute Renal Failure Characteristics Categories Prerenal Intrarenal Postrenal Etiology Hypoperfusion Parenchymal damage Obstruction BUN value Increased Increased increased Creatinine Increased Increased Increased Urine output Decreased Varies, often decreased Varies, may be decreased, or sudden anuria Urine sodium Decreased to < 20 mEq/L Increased to >40mEq/L Varies, often decreased to 20mEq/L or less Urinary sediment Normal, few hyaline casts Abnormal casts and debris Usually normal Urine osmolality Increased to 500mOsm About 350 mOsm similar to serum Varies, increased or equal to serum Urine specific gravity Increased Low normal Varies
  • 23.
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  • 46.
  • 49.
  • 50.
  • 52. HEMODIALYSIS Patient Access Vascular catheter A-V fistula Synthetic vascular graft
  • 54.
  • 55.
  • 56.
  • 57.