3.  Polyuria
 Nocturia
 Urinary frequency
 Normal urine output ? 800 – 2500 ML/Day

4.  Physiological - primary polydipsia
 Pathological – diabetes insipidus

5.  Burning micturition
 Increased frequency
 increased Urgency
 A/W disorders of urinary tract

6.  Inability to retain urine in bladder
 Neurogenic incontinence
 Stress incontinence
 Mechanical incontinence
 Overflow incontinence
 Psychogenic incontinence
 Functional incontinence

7.  Enuresis
 Oliguria
 Anuria
 Diuresis
 Natriuresis

8.  Deterioration of renal functions resulting in
reduced GFR leading to accumulation of
urea ,creatinine , electrolytes ,and non
nitrogenous substances
 ARF
 CRF

9.  Oliguria
 Anuria
 Volume overload
 Hyperkalemia
 Metabolic acidosis
 Hypoalcemia
 Anorexia , nausea , vomiting , muscle
twitching , fits , coma

10.  Sudden reduction in function of kidney A/w
rapid rise in urea and creatinine
 Pre renal
 Renal
 Post renal

11.  Pre renal – severe hemorrhage , shock ,
hypovolemia , burns , septicaemia
 Renal – glomerulonephritis , acute tubular
necrosis
 Post renal – urinary tract obstruction

12.  Slow insidious onset
 Irreversible loss of renal functions
 Leading to uremia
 Manifesting as excretory , metabolic ,
hematological , endocrinal functional
abnormalities

13.  Maintenance of adequate water and
electrolyte balance
 Control of infection
 Control of BP
 Acid base balance
 Diet
 Dialysis

14.  Congenital disorders
 Vascular disorders
 Glomerular disorders
 Tubulointestitial disorders
 Obstructive disorders

16.  Massive proteinuria and associated
complications
 Hypoalbuminemia
 Edema
 Hyperlipidemia
 Lipiduria
 Hypercoagulability

18.  Haemodialysis
 Peritoneal dialysis

19.  Functions as artificial kidney in patients with
non functional kidneys
 To treat patients in uremic coma
 Uses the principle of diffusion of solutes
through a semi-permeable membrane
 Can never replace a normal kidney
 Does not provide endocrinal , hematological
function of kidney

20.  Dialyzing fluid
 Uses heparin as an anti-coagulent
 Drains blood from the patient through AV
fistula or large veins
 Semi-permeable membrane allows passage
of all solutes except proteins
 At any given time artificial kidney contains
500ml of blood

21.  Used in both ARF and CRF
 Needs hospitalization and monitoring
 Needs AV fistula in CRF for repeated uses
 One cycle runs for 4- 6 hours
 Clears urea at the rate of 100 – 225 ml/min

24.  Peritoneal membrane is used as dialyzing
membrane
 No need for hospitalization
 Used in young children and older individuals
 Also known as CAPD
 Two liters of dialyzing fluid is injected into the
peritoneum
 Placement of permanent peritoneal catheter

25.  Exchange happens for 15 min
 Dialyzing fluid drained out and measured
 One cycle for every 6 hours
 Strict i/o chart is maintained

26.  Irreversible or terminally damaged kidneys
 ESRD
 Donor – cadaveric
sibling
 isogenic or allogenic
 Left kidney is preferred
 Rt iliac fossa is preferred
 Immunosupression needed- prednisolone ,
cyclosporine

27.  Substances increasing urine output
 By increasing water excretion
 Diuresis occurs along with natriuresis
 Loss of both water and solutes
 Used to reduce ECF volume

28.  Depending upon their ability (effectiveness)
they are classified under
 High efficacy diuretics - Loop diuretics
 Medium efficacy – Thiazides
 Weak diuretic -
 Osmotic diuretic
 Carbonic anhydrase inhibitors
 Aldosterone antagonist
 Sodium channel blockers

29.  Diuretics acting on PCT
 Diuretics acting on loop of henle
 Diuretics acting on DCT and CD
 Potassium sparing diuretics

30.  Acting on loop of TAL
 Inhibiting Na- k- 2cl symporter
 High efficacy diuretiics
 Furosemide , bumetanide

31.  Acts on early DCT
 Inhibits Na –Cl symport
 Medium efficacy drugs
 Hydrochlorthiazide

32.  Site of action is PCT
 Inhibits H+ secretion thro Na H antiport
 Causes loss of Na and bicarbonate
 Acetazolamide ..

34.  Mannitol , glycerol , isosorbide
 Major site of action PCT
 Causes increased osmolarity in the tubules
 Loss of water through diffusion

35.  Aldosterone antagonist
 EnaC inhibitors
 Acts on DT ,CD
 Spironolactone , amiloride ,