Urinary system renal dysfunction

TICARCILLIN DISODIUM Use IV therapy in higher doses in serious urinary tract and systemic infections. IM injections should not exceed 2 g/injection. Adjust dose in renal dysfunction. 

Nitrofurantoin is administered orally and is rapidly and almost completely absorbed from the small intestine only low levels of activity are achieved in serum because the drug is rapidly metabolized. Relatively high protein binding (about 70%) also affects serum levels, reducing potential for systemic toxicity and alteration of intestinal flora. Relative tissue penetration is much lower than other antimicrobials for UTIs, and therefore, nitrofurantoin is not indicated in the therapy of infections such as pyelonephritis and renal cortical or perinephric abscesses. Nitrofurantoin is rapidly excreted by glomerular filtration and tubular secretion to yield effective urinary levels. In moderate to severe renal dysfunction, toxic blood levels may occur while urinary levels may be inadequate. The drug is inactivated in the liver. 

Many potential agents of chemical warfare have little to no direct injurious effect on the kidney or urinary system, but instead may cause indirect renal injury and/ or urinary dysfunction. Nitrate esters used as explosives can cause profound hypotension with the potential to result in renal ischemia secondary to decreased renal perfusion (Gahagan and Wismer, 2012). Metabolic acidosis, proteinuria, glucosuria, and myoglobinuria were reported in a survey of five human cases of cydonite... 

Assessing sodium concentration is of clinical relevance as low urine sodium concentration may indicate dehydration, while a relatively high urine sodium concentration suggests acute renal failure. Lvova and coworkers (2009) proposed an E-tongue composed of chemical sensors to detect urinary system dysfunctions and creatinine levels. The electrochemical system was composed of miniaturized metallic sensors and ISEs with PVC solvent polymeric membranes. The device enabled the correct classification of urine samples from healthy volunteers, according to creatinine levels and to predict the creatinine content of urine. 

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