3.8 NEPHROLOGY
Nephrology refers to a branch in medicine, studying with the diagnosis of diseases of kidneys and the treatment of these diseases.
Kidney anatomy ????
3.8.1 The micro-structure of the Juxtaglomerular complex and its function.
The Juxtaglomerular complex refers to a region of a nephron which is specialized, where the afferent arteriole as well as the Distal Convoluted Tube (DCT) meet each other directly and making contact.
It consists of the following:
The Juxtaglomerular complex is made up of Juxtaglomerular cells of the afferent arteriole, which is smooth muscle cells that’s modified which includes renin. The renin is contained within the granulated cells, which is innervated sympathetically, where it performs the function of sensing blood pressure. Na+ sensors’s, such as macula densa cells of the Distal Convoluted Tube, senses the changes which occur in the solute concentration as well as the rate of flow of the filtrate. Connections are formed by the Juxtaglomerular mesangial cells through the actin and microtubules, which then allows
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It makes use of the potential of the body as the dialysis system offered by the peritoneal cavity as well as the membrane. Dialysis takes place when clean dialysate fluid is instilled into the cavity, through the catheter, giving it time. During this given time, processes such as osmosis, diffusion and pressure gradient will cause excess water as well as the waste from the blood to cross the semi permeable membrane of the abdominal wall and into the dialysate. The dialysate filled with unwanted waste will be drained away as well as new and clean dialysate will be instilled. For this exchange to occur, it can either be done manually also known as continuous ambulatory peritoneal dialysis (CAPD), or it can be performed by a machine, which is known as automated peritoneal dialysis
Human body and its health problems had been unknown for centuries until the evolution of the medical field in the late 1800s which lead to a rise in the average life expectancy from thirty six to a sweeping seventy eight. Then specialists started to identify the structure and the function of each organ. That’s when they found how important some organs as well as the human body cannot work properly without it. The kidney is one of those organs due to how fundamental it can
On this date worker visited Mr. Johnny Hyde at Devita Dialysis Clinic, for the purpose of informing Mr. Hyde the department had received his bank statements from First Bank of Jasper. Mr. Hyde wanted to know what charges showed and worker explained to Mr. Hyde the multiply charges on the account that matched with Mr. Joey Hunt's Facebook home page. Mr. Hyde stated, "I knew he stole my money and I want him arrested. " Worker explained she would give the information to Walker County Police Department.
Ms. Turner is a certified hemodialysis technician who functions in the role of Lead Machine Instrument in the Hemodialysis Department. She is responsible for the water purification system under the supervision of the Nurse Manager which is the most critical component to providing the Veteran with their hemodialysis treatment. She is also responsible for the unit inventory and because of her attention to detail the Veterans’ needs are fulfilled and without delay in care. Her position requires specialized advanced knowledge and skill which provides for a safe and efficient environment for Veterans to receive their treatments. In addition to these roles and responsibilities, Ms. Turner functions in the role of a patient care technician providing
The α2- globulin, Angiotensinogen is secreted from the liver. Renin in turn hydrolyzes the plasma globulin present in Angiotensinogen which acts as a precursor protein to form the precursor hormone Angiotensin I. Angiotensin I in its inactive state is converted to Angiotensin II which is active, this is done by angiotensin converting enzyme (ACE) secreted from the lungs (Ghany, 2011).. ACE also cleaves bradykinin to inactivate it producing fragments of the inflammatory mediator. Angiotensin II is present as an octapeptide acts as a vasoconstrictor hormone that results in the increase of blood pressure, renal perfusion and filtration rate by the glomerulus. Angiotensin II acts as a mediator for the Renin-Angiotensin-Aldosterone system, it does this by activating Angiotensin type 1 (AT1) receptor and Angiotensin type 2 (AT2) receptor.
Dialysis basically acts as an artificial kidney by filtering the blood of the patients on it. Dialysis can be both a good and a bad thing. The good in it is works just like a kidney would for a temporary fix, the bad is that sessions last three hours, several times a week. Dialysis is very harsh on the patient’s bodies, especially the ones that become dependent on it. It basically drains their bodies and causes them to become very weak and most of them aren’t able to work anymore.
The oral bioavailability of Tritace is 55%. The absorption is not significantly affected by food and the duration of action is 24 hours (Drugs.com, 2013). 2.0 Physiology of Renin-Angiotensin-Aldosterone System (RAAS) Baroreceptors located in the aortic arch and carotid sinuses detect changes in blood pressure. When a drop in blood pressure is detected, the medulla oblongata in the brain stimulates the juxtaglomerular kidney cells to secrete renin.
These receptor elements then respond to the changes in H+ concentration in the interstitial fluid in the brain, causing ventilatory and circulatory adjustments during hypercapnia and chronic disturbances of acid-base balance (O'Regan & Majcherczyk, 1982). Similarly, the peripheral chemoreceptors also sense the increase in pH and would signal to the respiratory centers via the glossopharyngeal and vagus nerves. The peripheral chemoreceptor drive can modulate central chemosensitivity during hypercapnia (O'Regan & Majcherczyk, 1982). Both central and peripheral chemoreceptors would send fewer impulses to the respiratory centers (central: the medulla oblongata, peripheral: the aortic and carotid bodies).
These structures filter the blood by hydrostatic and osmotic pressure gradients, producing a liquid containing mineral, wastes and water called glomerular filtrate. The purified blood is returned to the body while the filtrate passes into the renal tubule. The blind end of the nephron continues as the renal tubule, which comprises the proximal convoluted tubule (PCT) of 15mm long and 55m diameter, the descending limb of the loop of henle, the ascending limb of the loop of henle and finally the distal convoluted tubule (DCT). The renal tubule particularly distal collecting tubule opens into the collecting duct. As the filterate passes along the renal tubule, a network of tiny blood vessels called the peritubular capillaries reabsorbs useful substance such as Na+, Cl–, H2O and urea from it and secretes
The doctor’s ultimate goal is to avoid the need for dialysis or kidney
Over the years the procedure of extracting the Kidney has changed dramatically. There have been several medical breakthroughs in the 21st century. One incredible advancement was the Laparoscopic Nephrectomy. A Laparoscopic Nephrectomy is a surgical performance including a series of small incisions,
Then the vein clamps are removed first then the artery ones are removed. Now that the kidney is in place attention is give to the urethra replantation. Again anastomosis is performed and the kidney is now fully functional. The wound is stitched layer by layer. The operation is complete
It also shows many important functions such as thermoregulation, sensory perception, immunologic surveillance, resistor of insensible fluid loss
Abstract Diabetic vascular complication is a leading cause of diabetic nephropathy, a progressive increase in urinary albumin excretion coupled with elevated blood pressure leading to declined glomerular filtration and eventually end stage renal failure. There is growing evidence that activated inflammation is contributing factor to the pathogenesis of diabetic nephropathy. Meanwhile, IL-18, a member of the IL-1 family of inflammatory cytokines, is involved in the development and progression of diabetic nephropathy. However, the benefits derived from the current therapeutics for diabetic nephropathy strategies still provide imperfect protection against renal progression. This imperfection points to the need for newer therapeutic agents that have potential to affect primary mechanisms contributing to the pathogenesis of diabetic nephropathy.
Embryological origin Embryological origin has been considered the most acceptable theory to explain the prevalence of variants in renal vasculature. The theory proposed by W.Felix is the most quoted and widely accepted explanation of the embryological origin of the variants in renal vasculature. The mesonephros, in a 5th week human embryo, is supplied by a group or arteries arising from the lateral surface of the abdominal aorta. As given in Fig 1a.
The urinary system, as described by Colbert, Ankney & Lee (2013), is the system in our body that produces urine through the processes of filtration, reabsorption and secretion. The production of urine helps to control the body’s fluid and electrolyte balance, eliminates waste products and removes salts and excess fluids from the blood. When this system is functioning properly, unnecessary waste is eliminated from the body, and the substances needed by the body are reabsorbed back in to the blood stream for future use. There are various pathologies that affect the urinary system due to malfunctioning anatomical structures. In the case of Polycystic Kidney Disease (PKD), the pathology is genetic (Colbert, Ankney & Lee (2013).