Friday, March 27, 2020

What is kidney function? Why does kidney deteriorate?


What is kidney function? Why does kidney deteriorate?
Human Kidney

The kidneys are coupled organs, which perform many functions. They are found in many types of animals, including vertebrates and some invertebrates. They are an essential part of our urinary system and they also perform homeostatic functions like electrolyte control, acid-base balance, and blood pressure control etc. These act as natural purifiers of blood in the body and remove waste, which is then sent to the bladder. When producing urine, the kidneys excrete waste materials such as urea and ammonium; The kidneys are also responsible for the reabsorption of water, glucose and amino acids. The kidneys likewise produce hormones, including calcitriol, renin, and erythropoietin.

Retroperitoneum in the posterior part of the abdominal cavity
The kidneys located in the (retroperitoneum) receive blood from the pair of renal arteries and flow it into a pair of renal veins. Each kidney excretes urine into a ureter, which is itself a paired structure emptying into the bladder.

The study of kidney function is called renal physiology, while the therapeutic method related to kidney diseases is called nephrology. Kidney diseases are of a wide variety, but specific medical symptoms are often seen in patients with kidney disease. Common medical conditions associated with the kidney include nephritic and nephrotic syndromes, renal cysts, acute renal lesions, chronic kidney diseases, urethral infections, renal calculi and ureteric obstruction. Several types of kidney cancer also exist; The most common adult renal cancer is renal cell carcinoma. Cancer, cyst and some other kidney conditions can be managed by evacuating the kidney, or by nephrectomy. When renal function, measured by glomerular filtration rate, continues to worsen, dialysis and kidney transplantation may be its treatment options. Although stones are not very harmful, they can also cause pain and problems. The process of removing the stones involves healing by sound waves, breaking the stone into small pieces and pulling it out of the way of the bladder. Intense pain in the medial / lateral segments of the back of the back is a common symptom of appendicitis.

Kidney Location:

In humans, kidneys are located in the abdominal cavity in a space called retroperitoneum (retroperitoneum). Their number is two and one of these kidneys is located one on either side of the spinal cord; They are approximately at the vertebral level from T12 to L3. The right kidney is located just below the diaphragm and behind the liver, and the left is below the diaphragm and behind the spleen. There is an adrenal gland at the top of each kidney. The right kidney is slightly lower than the left and the left kidney is slightly more moderate than the right due to the asymmetry found in the abdominal cavity due to the liver. The upper (cranial) part of the kidney is partially protected by the eleventh and twelfth ribs, and the entire kidney and adrenal glands are covered by fat (perineal and perineal fat) and renal fascia. Each adult kidney weighs between 125 and 170 grams in men and 115 to 155 grams in women. Typically the left kidney is slightly larger than the right.

The structure of Kidney

The kidney is bean-shaped, with concave and convex surfaces found in each kidney. The concave surface, called the renal hilum, is the point from which the renal artery enters this organ and the renal vein and ureter exit. The kidney is surrounded by hard fibrous tissues, renal capsule, which itself is surrounded by perinephric fat, renal bandage (of Gerota) and paranephric fat. The anterior (front) border of these tissues is the peritoneum, while the posterior (posterior) border is the transversalis stripe.
The upper border of the right kidney is adjacent to the liver; And the left border is attached to the spleen. Therefore, both of these go down when breathing.

The kidney is about 11–14 cm long, 6 cm wide and 3 cm thick.
The renal substance, or parenchyma, is divided into two main structures: the renal cortex in the upper part and the renal medulla within it. Altogether these structures form a figure of eight to eighteen renal segments of cone shape, each containing a renal bark covering a part of the medulla, called the renal pyramid (of Malpighi). Between the renal pyramids are bark protrusions, Those are called renal columns. Nephrons, the urine-producing functional structures of the kidney, extend from the bark to the medulla. The initial purification part of a nephron is the renal corpuscle located in the bark, followed by a renal tubule known deep into the medullary pyramids via the bark. A medullary ray, a part of the renal bark, is a group of renal tubules that empty into a single collecting tube.

The end of each pyramid, or papilla, carries urine into the minor calyx, the minor follicle empties into the major calyces and the main follicle empties into the renal pelvis. That the ureter becomes.

The kidneys participate in homeostasis of the entire body by controlling acid-base balance, electrolyte concentration, extracellular fluid volume, and blood pressure. The kidneys perform these homeostatic functions both independently and in association with other organs, particularly the organs of the endocrine system. The fulfillment of these endocrine functions requires synergy between various endocrine hormones, including renin, angiotensis II, aldosterone, antidiuretic hormone, and articular natriuretic peptide, etc.

Many of the functions of the kidney are accomplished by relatively simple mechanisms of refining, reabsorption and secretion that occur in the nephron. Refining, which occurs in the renal corpuscle, is a process by which cells and large proteins are filtered from the blood and an ultrafiltrate is formed, which will eventually form urine. The kidneys produce 180 liters of ultrafiltrate a day, a large percentage of which is regenerated and about 2 liters of urine is produced. The transport of molecules from this ultrafiltrate into the blood is called reabsorption. The secretion is its reverse process, in which molecules are sent in the opposite direction, from blood to urine.

Osmotic control.

Any significant increase or fall in plasma osmolality is identified by the hypothalamus, which communicates directly with the posterior mucous gland. When osmolality increases, this gland secretes the antidiuretic hormone ADH, resulting in water reabsorption by the kidneys and increased urine concentration. These two factors work together to bring plasma osmolality back to normal levels.

ADH attaches to the main cells located in the collecting duct, which transfer aquaporins to the medulla, so that water can leave the normally impermeable medulla and be reabsorbed into the body by the vasa recta , Thereby increasing the amount of plasma in the body.

There are two systems that produce hyperosmotic medulla and thus increase the amount of plasma in the body: urea recycling and 'single effect'.
Urea is usually excreted from the kidneys as a waste material. However, when plasma blood volume is low and ADH is released, the open aquaporins are also susceptible to urea. This allows urea to form a hyperosmotic solution that 'attracts' water by leaving a hyper collecting tube and entering the marrow. Urea can then re-enter the nephron and be re-excreted or recycled depending on whether ADH is still present.

The 'single effect' describes the fact that the thick ascending limb of the Loops of Henley is not permeable by water, but is permeable by NaCl. This means that a counter-flow system is created by which the medulla becomes more concentrated and if the collecting duct is opened by ADH, it must be complied with a osmolarity ratio of water.

Blood pressure control

Long-term blood pressure control is mainly dependent on the kidneys. This is mainly through the maintenance of extracellular fluid subdivision, whose size depends on the plasma sodium concentration. However, the kidneys cannot directly estimate blood pressure, but changes in the delivery of sodium and chloride to the distal parts of the nephron alter the secretion of the renal fermentin used by the kidney. When the extracellular fluid subdivision is expanded and blood pressure is high, the delivery of these ions increases and the secretion of renin decreases. Similarly, when the extracellular fluid subdivision is compressed and blood pressure is low, the delivery of sodium and chloride decreases and the renin secretion increases in response.

Renin is the main individual from a progression of substance flag-bearers that together structure the renin – angiotensin component. Changes in renin in the end modify the yield of this system, basically angiotensin II and aldosteron. Every hormone demonstrations through a few systems, however both increment the retention of sodium chloride by the kidneys, in this way growing the extracellular liquid subdivision and raising pulse. At the point when renin levels are expanded, the convergence of angiotensin II and aldosterone increments, bringing about expanded reabsorption of sodium chloride, development of extracellular liquid subdivision, and expanded circulatory strain. On the other hand, when renin levels are low, angiotensin II and aldosterone levels decline, causing withdrawal of extracellular liquid subdivision and diminished circulatory strain.

Hormone Flow:

The kidneys discharge an assortment of hormones, including erythropoietin, calcitriol, and renin. Erythropoietin is discharged as a response to hypoxia (low degree of oxygen at the tissue level) in the renal stream. It catalyzes erythropoiesis (creation of red platelets) in the bone marrow. Calcitriol, the synergist type of nutrient D, empowers intestinal retention of calcium and renal reabsorption of phosphate. Renin, which is a piece of the renin – angiotensin – aldosterone component, is a chemical engaged with the control of aldosterone levels.

Hanta Virus

What is kidney disappointment?

Kidney disappointment is where the kidneys can't adequately expel these poisons from the blood. Components that may harm your kidney might be: presentation to lethal substances present in nature or in drugs; Either intense or constant infection, kidney injury, and extreme type of lack of hydration.

What are the 5 phases of kidney disappointment?

These 5 phases of interminable kidney disappointment are as per the following:

Stage 1: During this stage, there is just mellow harm to the kidney and no side effects are seen. Yet, on the off chance that you feel a few changes, at that point you should see a specialist. On the off chance that EGRF is over 90 in arrange one, the kidney is solid and working admirably. Specialists check for kidney illness by testing the degree of protein present in your pee.

These are the things you ought to do to hinder arrange 1 kidney illness:
  1. Control your glucose if there should be an occurrence of diabetes.
  2. Maintain your blood pressure
  3. Keep a healthy diet
  4. Avoid smoking or tobacco
  5. Exercising regularly
  6. Healthy lifestyle and maintaining proper weight.

Stage 2: During stage 2 of kidney disease there are no symptoms and the damage is mild. But you should see a doctor as soon as possible to prevent further damage. In stage 2 the EGRF occurs between 60–89 which means that the kidneys are functioning well and are healthy. But still, you should go to the doctor because although EGRF  In general, there may be some abnormalities such as excess protein content in the urine or some physical damage to the kidney.

These are the things that you should do to reduce 2 kidney disease:

  1. Control your blood sugar in case of diabetes.
  2. Maintain your blood pressure
  3. Keep a healthy diet
  4. Avoid smoking or tobacco
  5. Exercising regularly
  6. Healthy lifestyle and maintaining proper weight.

Stage 3: Kidney disease during the stage 3 causes kidney failure and stops functioning properly. There are two stages in stage 3 kidney disease which are stage 3a and stage 3b. If a person is suffering from Stage 3A then the EGFR is between 45–59 and if the condition is 3B then the EGRF is between 30–40.

The following are the symptoms of stage 3 kidney disease:
  1. Back pain
  2. Urination problem
  3. Swelling of hands and feet
  4. Stage 3 kidney disease can cause a large number of complications in a person's body which can be high blood pressure, anemia, and bone disease.

Stage 4: During the fourth stage of kidney disease, the kidneys are severely damaged and they stop functioning properly. Kidney disease should be taken seriously in the fourth stage as it becomes the last stage before complete kidney failure.

If you do not want kidney disease, then you should do the following:
Make regular appointments for nephrologists to get the best treatment
Seeing a dietician so that you follow the proper diet to keep yourself healthy
If you are suffering from any of these, then get your blood pressure and diabetes checked.

Stage 5: This means that the kidney disease is in its final stage or is very close to failure.

Symptoms of kidney failure are:
  1. Itching
  2. Muscle cramp
  3. No appetite
  4. Nausea and vomiting
  5. Back pain
  6. Urination problem
  7. Respiratory distress
  8. Trouble sleeping
Once the kidney fails, you are ready for dialysis or kidney transplant.

What are the symptoms and signs of kidney failure?

Following are the symptoms that come with renal or kidney failure:
  1. Confusion
  2. Be nauseous
  3. Fatigue
  4. Caesar
  5. Coma status
  6. Decreased urination
  7. Swelling of body parts
  8. Pain in chest
  9. Shortness of breath

Kidney failure or damage can occur due to the following reasons:

  1. Heart disorder
  2. Hartburn
  3. Allergies
  4. Severe liver burn or scar
  5. Infections such as: sepsis.
  6. High blood pressure or hypertension

Anti-inflammatory drugs can also block blood flow to the kidney.
Other causes of kidney failure are:

  1. Lupus
  2. Blood clots around kidney area
  3. Drug and Alcohol Abuse
  4. Vasculitis (inflammation of blood vessels)
  5. Chemotherapy drugs
  6. Multiple myeloma (cancer that grows in plasma cells of the bone marrow area)
  7. Glomerulonephritis (inflammation of the blood vessels of the kidney)
  8. Scleroderma and some antibiotics.

Some factors that may contribute to urination difficulties and eventually lead to kidney failure; 
They are - blood clots in the urinary tract, kidney stones, injury to the nerves that control the bladder and or increased prostate.

What causes kidney failure?

Kidney failure occurs when the organ is completely damaged and kidney failure can have many causes or conditions, including:
Reduced blood flow in kidney:
If there is a sudden loss of blood in the kidneys or the bleeding stops in the kidney, then it promotes kidney failure. There may be other conditions with kidney failure, including: heart attack, heart disease, dehydration, burning sensation, allergies, severe infections, liver failure.

Urine elimination problem:

Our body eliminates toxic and acidic substances from the body in the form of urine. But when this urine starts to accumulate in the body and cannot go out, it creates pressure on the kidney and overloads it. It can cause kidney failure and even some types of cancer.

Some diseases also cause obstruction of the urinary tract, including:
Prostate, colon, cervical, bladder.
There may be other conditions that can cause urinary obstruction:
Kidney stones, enlarged prostate, blood clots in the urinary tract or any type of damage in the urinary tract.

Some other problems may also occur:

  1. Infections in your kidney
  2. Alcohol or liquor
  3. Kidney overload of toxins
  4. Antibiotics
  5. Unman aged diabetes
  6. Chemotherapy drugs.


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