KIDNEY- RENAL :- 

Each kidney at birth is composed of approx one million functional units called nephrons, these beings far more than what are needed by the body. As a part of the natural degenerative processes, there is a gradual loss in the number of nephrons after the age of 30years.

A large volume of blood, nearly 1300ml/minute, which is about one fourth of the cardiac output at rest, flows through kidneys.

“The important function of the kidney is to maintain homeostatic balance with respect to fluids, electrolytes and organic solutes.”

The normal function of the kidney can be performed within wide range of dietary fluctuation pf sodium, water and other solutes.

The kidney receives 20% of the cardiac output which allows the filtering of approx. 1600ltr/day of the blood.

Approx. 180ltrs of ultrafilterate is produces by filtering the blood and through active process of reabsorbing certain components and secreting others, the composition of fluid is changed into 1.5lts of urine excreted in average day.

FUCTIONS OF KIDNEYS :-

• Excretory and regulatory function
• Endocrine function
• Metabolic function

GENERAL CAUSES OF KIDNEY DISEASES :- 

Various factors affect the kidney and disturb the normal functioning of the nephrons.

• Inflammatory and degenerative disease- There may be short term inflammation of the blood capillaries an membrane of the nephrons as seen in glomerulonephritis. The inflammation may involve the entire  nephron in some case. Nephhrotic leading to chronic renal failure. May develop disturbing the metabolism of protein, electrolytes aand water.
• Infection and obstruction
• Other disease
• Toxins
• Genetic factors

Risk factors :-

• Sociodemographic  factors-
• Older age
• Member of racial or ethic minority
• Exposure to certain chemical and environmental condition
• Low income or education level

Clinical factors :-

• Poor glycemic control in diabetes
• Hypertension
• Autoimmune disease
• Systemic infection
• Urinary tract infection
• Urinary stones
• Lower urinary tract obstruction
• Neoplasia
• Family history of CKD
• Recovery from acute kidney failure
• Reduction in kidney mass
• Exposure to certain nephrotoxic drugs
• Low birth weigth

RENAL DISEASE :-

The manifestation of renal disease are direct consequences of the portions of the urinary tract symptom most affected.

1.GLOMERULAR DISEASE(DUE TO INFFLAMATION OF NEPHRONS) :-

• GLOMERULONEPHRITIS
• NEPHROTIC SYNDROME

2. Disease of the table and interstitial(due to metabolic injury or traumatic insult to the normal kidney) :-

• ACUTE RENAL FAILURE(ARF)
• CHRONIC INTERSTITIAL NEPHRITIS
• MEDULLARY CYSTIC DISEASE
• FANCONI’S SYNDROME
• RENAL TUBULAR ACIDOSIS(RTA)
• PYELONEPHRITIS

3. Progressive nature of Renal Disease :

• CHRONIC KIDNEY DISEASE/ CHRONIC RENAL FAILURE/PRE-ESRD
• END STAGE RENAL DISEASE(ESRD)

CLINICALLY SYMPTOMS :-

• Fatigue
• Swelling on hand and feet
• Water retention
• Feeling dizzy, weak
• Puffy face
• Shortness of breath
• Feeling itchy

DIAGNOSIS AND TEST :-

Urea, Uric Acid, Blood Urea Nitrogen, Creatinine, Urea/ Creatinine Ratio , BUN Creatinine Ratio, serum protein. GFR

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