肾内科课件 outline
合集下载
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
Outlines of Kidney Disease
PanLing
A Review of Urinary System
What is the urinary system composed of? kidney ureter bladder/cyst urethral associated vessels and nerves
② Proteinuria results from overproduction of circulating
such as Bence jones proteins associated with multiple myeloma.
③ glomerular proteinuria:
cause: abnormalities in the glomerular filtration barrier
General considerations
the disease evaluation includes:
an estimation of disease duration a careful urinalysis glomerular filtration rate other datas
1. DISEASE DURATION
urine albumin /urine creatinine :30-300ug/mg
Classification of proteinuria:
①.functional proteinuria. cause: acute illness,exercise, and orthostatic position. characteristic: transient generally ＜1g/d
renal disease may be acute or chronic, for instance,
Acute renal failure: worsening of renal
function over hours to days
chronic renal failure : a loss of renal function over months to years
Vasoconstriction: renin, angiotensin Ⅱ Vasodilatation: kinin,prostaglandin
• Non-vasoactive substance:
erythropoietin renal 1-alpha hydroxylase(calcitriol)
• Distal Tubule: secrete hydrogen, potassium, ammonia
• The Limbs of Henle’s Loop: urine inspissation and dilution
Endocrine function
• Vasoactive substance:
APPROACH TO THE PATIENT WITH RENAL DISEASE
General considerations
A patient will present with renal disease in one of two ways:
discovered incidentally with evidence of renal damage
尿液检查
（uronoscopy）
1) PROTEINURIA
➢ what is proteinuria?
protein in the urine ＞150mg/24hours or (+) urine protein/urine creatinine ＞200mg/g
➢ what is microalbuminuria?
2. URINALYSIS
It include: dipstick examination: gravity, pH, protein, hemoglobin, nitrites, ketones,etc.Leabharlann Baidu
microscopic examination: searches for all formed elements---cells, casts, and infecting organisms.
Evaluating kidney damage by laboratory and instrumental examination
Urinalysis Urine volume Kidney function:CCr、eGFR Imaging examination Renal biopsy
2 character : size-selective barrier charge-selective barrier
3 function：an ultrafiltrate of plasma.
Tubular function
• Proximal Tubules: reabsorption 100% Glucose ,amino acid 90% bicarbonate 70% water,natrium secrete hydrogen
An ability to excrete metabolic substance (mainly nitrogenous wastes)
Endocrine function
Glomerolar function
1 strucure: endothelial basement membrane epithelial
The functional unit of the kidney is the nephron.
The nephron include： the renal corpuscle （glomerulus Bowman capsule) the tubule
Kidney function
An ability to maintain fluid , electrolyte and acid-base balance
PanLing
A Review of Urinary System
What is the urinary system composed of? kidney ureter bladder/cyst urethral associated vessels and nerves
② Proteinuria results from overproduction of circulating
such as Bence jones proteins associated with multiple myeloma.
③ glomerular proteinuria:
cause: abnormalities in the glomerular filtration barrier
General considerations
the disease evaluation includes:
an estimation of disease duration a careful urinalysis glomerular filtration rate other datas
1. DISEASE DURATION
urine albumin /urine creatinine :30-300ug/mg
Classification of proteinuria:
①.functional proteinuria. cause: acute illness,exercise, and orthostatic position. characteristic: transient generally ＜1g/d
renal disease may be acute or chronic, for instance,
Acute renal failure: worsening of renal
function over hours to days
chronic renal failure : a loss of renal function over months to years
Vasoconstriction: renin, angiotensin Ⅱ Vasodilatation: kinin,prostaglandin
• Non-vasoactive substance:
erythropoietin renal 1-alpha hydroxylase(calcitriol)
• Distal Tubule: secrete hydrogen, potassium, ammonia
• The Limbs of Henle’s Loop: urine inspissation and dilution
Endocrine function
• Vasoactive substance:
APPROACH TO THE PATIENT WITH RENAL DISEASE
General considerations
A patient will present with renal disease in one of two ways:
discovered incidentally with evidence of renal damage
尿液检查
（uronoscopy）
1) PROTEINURIA
➢ what is proteinuria?
protein in the urine ＞150mg/24hours or (+) urine protein/urine creatinine ＞200mg/g
➢ what is microalbuminuria?
2. URINALYSIS
It include: dipstick examination: gravity, pH, protein, hemoglobin, nitrites, ketones,etc.Leabharlann Baidu
microscopic examination: searches for all formed elements---cells, casts, and infecting organisms.
Evaluating kidney damage by laboratory and instrumental examination
Urinalysis Urine volume Kidney function:CCr、eGFR Imaging examination Renal biopsy
2 character : size-selective barrier charge-selective barrier
3 function：an ultrafiltrate of plasma.
Tubular function
• Proximal Tubules: reabsorption 100% Glucose ,amino acid 90% bicarbonate 70% water,natrium secrete hydrogen
An ability to excrete metabolic substance (mainly nitrogenous wastes)
Endocrine function
Glomerolar function
1 strucure: endothelial basement membrane epithelial
The functional unit of the kidney is the nephron.
The nephron include： the renal corpuscle （glomerulus Bowman capsule) the tubule
Kidney function
An ability to maintain fluid , electrolyte and acid-base balance