Renal system kidneys

People with Neurologic Dysfunction or Kidney Disease. This population is unusually susceptible to lead exposure. The neurologic and renal systems are the primary target organs of lead intoxication, which may become overburdened at much lower threshold concentrations to elicit manifestations of lead intoxication (Benetou-Marantidou et al. 1988 Chisolm 1962, 1968 Lilis et al. 1968 Pollock and Ibels 1986). 

Vasopressin (antidiuretic hormone) is a peptide synthesized in the hypothalamus and secreted from the neurohypophysis of the pituitary gland. This substance plays an important role in the long-term regulation of blood pressure through its action on the kidney to increase reabsorption of water. The major stimulus for release of vasopressin is an increase in plasma osmolarity. The resulting reabsorption of water dilutes the plasma toward its normal value of 290 mOsM. This activity is discussed in more detail in Chapter 10 (the endocrine system) and Chapter 19 (the renal system). 

Severe pain in the loin lasting several hours and which is recurring requires referral to investigate underlying cause. One of the systems that need to be investigated is the renal system. Pain originating from kidney disorders and renal colic (renal calculi) initially presents with loin pain and may radiate to the back or spread downwards to the iliac fossa, suprapubic area and in males into the scrotum. 

Dopamine exhibits its primary action of the cardiovascular system, kidneys, and mesentery. It is used as a temporary agent for treating hypotension and circulatory shock caused by myocardial stroke, trauma, kidney rejection, and endogenous septicemia. The main indication for use of this drag is shock of various origins (cardiogenic, postoperational, infectious-toxic, anaphylactic), severe hypotension, and imminent renal insufficiency. Synonyms of dopamine are dopamin and inotropin. 

The renal system consists of the kidneys and their vasculature and innervation, the kidneys each draining through a ureter into a single median urinary bladder, and the latter draining to the exterior via a single duct, the urethra. The kidney has three major anatomical areas the cortex, the medulla, and the papilla. 

The primary function of the renal system is the elimination of waste products, derived either from endogenous metabolism or from the metabolism of xenobiotics. The latter function is discussed in detail in Chapter 10. The kidney also plays an important role in regulation of body homeostasis, regulating extracellular fluid volume, and electrolyte balance. 

Oxalic acid may have a direct corrosive effect on the eyes, skin, and digestive tract after contact. However, once absorbed (or produced as a result of the metabolism of other compounds), oxalic acid and other soluble oxalates react with calcium in the plasma to form insoluble calcium oxalate. Systemic formation of calcium oxalate may produce hypocalcemia directly. Precipitation of calcium oxalate in the renal system (proximal tubules of the kidney) may lead to local necrosis of the tubular epithelium, producing kidney dysfunction and electrolyte imbalance. Precipitation of calcium oxalate may also occur in the blood vessels, heart, lungs, and liver leading to local effects. 

Once bound to calcium, oxalate salts become insoluble and may precipitate in the renal system resulting in kidney malfunction and electrolyte imbalance. Renal damage may be due to vascular stasis. 

There is epidemiologic evidence to suggest an increased prevalence of duodenal ulcers in patients with certain chronic diseases, but the pathophysiologic mechanisms of these associations are uncertain. A strong association exists in patients with systemic mastocytosis, multiple endocrine neoplasia type 1, chronic pulmonary diseases, chronic renal failure, kidney stones, hepatic cirrhosis, and ai-antitrypsin deficiency. An association may exist in patients with cystic fibrosis, chronic pancreatitis, Crohn s disease, coronary artery disease, polycythemia vera, and hyperparathyroidism. 

The kidneys, bladder wall, and adrenals are most exposed organs. MAG3 is rapidly distributed in the extracellular fluid and excreted entirely by the renal system. The renal transit time is approximately 4 min, as is for OlH (Bubeck et al. 1987). 

MEDICATION MEMORY JOGGER Because the hepatic and renal systems are responsible for metabolizing and excreting all medications, monitoring the liver and kidney laboratory values is a pertinent nursing action. 

The renal system nephropathy and gradual deterioration of kidney functions. 

Mahoney CA, Arieff Al, Leach WJ Lazarowitz VC. (1983). Central and peripheral nervous system effects of chronic renal feiilure. Kidney Int 24, 170-177. 

Ruid volume regulation is necessary to maintain life. Decreased and inadequate fluid volume (i.e., hypovolemia) can result in decreased flow and perfusion to the tissues. Increased or excessive fluid volume (i.e., hypervolemia) can placed stress on the heart and cause dilutional electrolyte imbalance. It is clear that the renal system plays a vital role in fluid management. If the kidneys are not functioning fully, fluid excretion and retention will not occur appropriately in response to fluid adjustment needs. 2... 

The renal system is another major regulator of pH balance. The kidneys can control pH by secreting H+ from the body or retaining it to reverse an acidosis or alkalosis. The renal mechanism can correct an acidosis by reabsorbing CO, which then combines with water to form carbonic acid and bicarbonate, which is released into the bloodstream, and H+, as noted earlier in the carbonic acid-bicarbonate buffer system. The renal system can can correct alkalosis by excreting the CO, resulting in less bicarbonate formation. 

If the untreated patient survives the liver disease, pathological changes resulting from excess copper eventually appear in the central nervous system, kidneys, and cornea. At this stage, neurological and psychiatric symptoms may appear, and renal function is impaired. If untreated, the manifestations of copper toxicity result in death at an early age. 

Merck (2003) Principles of transplantation suppression of the immune system (2003) www.merck.com/mmhe/ print/secl6/chl87/chl87b.html Miller L, Soffer O, Nannan V (1989) Acquired renal cystic kidney disease in end stage renal disease an autopsy study of 155 cases. Am J Nephrol 9 322-328 Oniscu G, Brown H, Forsythe J (2004) How old is old for transplantation Am J Transplant 4 2067-2074 Pessione F, Cohen S, Durand D, Hourmant M, Kessler M, Legendre C (2003) multivariate analysis of donor risk fac-... 

---