nephrology

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nephrology

مشاركةبواسطة دكتور كمال سيد » الثلاثاء مايو 21, 2013 6:44 am

Internal structure of the Kidney - Anatomy Tutorial






Nephrology - Kidney and Nephron Overview






Nephrology - Glomerular Filtration
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مشاركةبواسطة دكتور كمال سيد » الثلاثاء مايو 21, 2013 7:09 am

Nephrology - Kidney Physiology Overview






Renin Angiotensin Aldosterone System
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Re: nephrology

مشاركةبواسطة دكتور كمال سيد » الأحد إبريل 06, 2014 5:59 pm

عارف يا دكتور ال

renal artery stenosis

ده يؤدى الى low intra glomerular pressure

وهذا يؤدى الى (decline of glomerular filtiration rate (GFR

وعارف ان استخدام ال ACEI يؤدى الى VD (vasodilatation) of efferent arteriole
وده يؤدى الى decline of GFR

يعنى لو استخدمت ACEI فى مريض عنده bilateral R.A.S هيدخل فى acute renal failur
_____________
من شرح دكتور اسامه محمود

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Re: nephrology

مشاركةبواسطة دكتور كمال سيد » الأربعاء يوليو 30, 2014 10:34 am

RENAL MEDICINE
http://www.webmd.com/urinary-incontinen ... he-kidneys

The kidneys are a pair of organs located in the back of the abdomen. Each kidney is about 4 or 5 inches long -- about the size of a fist.
The kidneys' function are to filter the blood. All the blood in our bodies passes through the kidneys several times a day. The kidneys remove wastes, control the body's fluid balance, and regulate the balance of electrolytes. As the kidneys filter blood, they create urine, which collects in the kidneys' pelvis -- funnel-shaped structures that drain down tubes called ureters to the bladder.
Each kidney contains around a million units called nephrons, each of which is a microscopic filter for blood. It's possible to lose as much as 90% of kidney function without experiencing any symptoms or problems.

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Kidney Conditions

Pyelonephritis (infection of kidney pelvis): Bacteria may infect the kidney, usually causing back pain and fever. A spread of bacteria from an untreated bladder infection is the most common cause of pyelonephritis.
http://www.webmd.com/a-to-z-guides/kidn ... treatments

Glomerulonephritis: An overactive immune system may attack the kidney, causing inflammation and some damage. Blood and protein in the urine are common problems that occur with glomerulonephritis. It can also result in kidney failure.
http://www.webmd.com/a-to-z-guides/chro ... c-overview

Kidney stones (nephrolithiasis): Minerals in urine form crystals (stones), which may grow large enough to block urine flow. It's considered one of the most painful conditions. Most kidney stones pass on their own but some are too large and need to be treated.
http://www.webmd.com/kidney-stones/unde ... nes-basics

Nephrotic syndrome: Damage to the kidneys causes them to spill large amounts of protein into the urine. Leg swelling (edema) may be a symptom.

Polycystic kidney disease: A genetic condition resulting in large cysts in both kidneys that impair their function.
http://www.webmd.com/a-to-z-guides/poly ... y-diseases

Acute renal failure (kidney failure): A sudden worsening in kidney function. Dehydration, a blockage in the urinary tract, or kidney damage can cause acute renal failure, which may be reversible.
http://www.webmd.com/a-to-z-guides/acut ... c-overview

Chronic renal failure: A permanent partial loss of kidney function. Diabetes and high blood pressure are the most common causes.
http://www.webmd.com/a-to-z-guides/chro ... c-overview

End stage renal disease (ESRD): Complete loss of kidney function, usually due to progressive chronic kidney disease. People with ESRD require regular dialysis for survival.

Papillary necrosis: Severe damage to the kidneys can cause chunks of kidney tissue to break off internally and clog the kidneys. If untreated, the resulting damage can lead to total kidney failure.

Diabetic nephropathy: High blood sugar from diabetes progressively damages the kidneys, eventually causing chronic kidney disease. Protein in the urine (nephrotic syndrome) may also result.
http://www.webmd.com/diabetes/tc/diabet ... c-overview

Hypertensive nephropathy: Kidney damage caused by high blood pressure. Chronic renal failure may eventually result.

Kidney cancer: Renal cell carcinoma is the most common cancer affecting the kidney. Smoking is the most common cause of kidney cancer.
http://www.webmd.com/cancer/understanding-kidney-cancer

Interstitial nephritis: Inflammation of the connective tissue inside the kidney, often causing acute renal failure. Allergic reactions and drug side effects are the usual causes.

Minimal change disease: A form of nephrotic syndrome in which kidney cells look almost normal under the microscope. The disease can cause significant leg swelling (edema). Steroids are used to treat minimal change disease.

Nephrogenic diabetes insipidus: The kidneys lose the ability to concentrate the urine, usually due to a drug reaction. Although it's rarely dangerous, diabetes insipidus causes constant thirst and frequent urination.
http://www.webmd.com/diabetes/guide/nep ... treatments

Renal cyst: A benign hollowed-out space in the kidney. Isolated kidney cysts occur in many normal people and almost never impair kidney function.
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مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 4:18 pm

Understanding Urinary Tract Infections -- the Basics

http://www.webmd.com/a-to-z-guides/unde ... ons-basics


What Are Urinary Tract Infections?
Urinary tract infections (UTIs) are bacterial infections in the body's urinary system -- the bladder, kidneys, ureters, and urethra. In the kidneys, the infection is called pyelonephritis; in the bladder, it is called cystitis

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Urinary tract infections are common in women. Children with UTIs may show different symptoms than adults

??Am I at Risk for a Urinary Tract Infection

: People with a higher risk of developing urinary tract infections include

People with conditions that affect the bladder's nerve supply (including diabetes, multiple sclerosis, *
* Parkinson's disease
(and spinal cord injuries
Older adults*
Pregnant women*
People who have any kind of obstruction blocking the passage of urine, such as a tumor, kidney stone, or an enlarged prostate
Those who use a contraceptive diaphragm or spermicide for birth control*
People who use a catheter, a tube placed into the bladder to drain urine from the bladder into a bag outside of the body
Men who engage in anal intercourse, who have HIV infection, or who have never been circumcised*

Most of the risk factors listed also increase the chance that a simple bladder infection may quickly become to a more serious kidney infection, or to sepsis (an infection that has entered the bloodstream). Pregnant women with kidney infections have a greater chance of delivering their babies prematurely

?? What Causes Urinary Tract Infections

Bacteria that are normally found in the gastrointestinal tract, such as E. coli, cause most urinary tract infections. Other bacteria that can cause urinary tract infections include staphylococcus, proteus, klebsiella, enterococcus, and pseudomonas

Some bladder infections in both men and women have been linked to two sexually transmitted organisms: Chlamydia trachomatis and mycoplasma. Another sexually transmitted organism, trichomonas, can cause similar symptoms

Women are more likely to get urinary tract infections, because the tube running from the bladder to the outside (the urethra) is much shorter than in men. Because the urethral opening is relatively close to the anus in women, bacteria from stool can easily contaminate the female urethra
A urinary tract infection in young women may be associated with sexual activity

In men, however, a bladder infection is almost always a symptom of an underlying disorder. Often, the infection has migrated from the prostate or some other part of the body, signaling problems in those locations. Or it may mean that a tumor or other obstruction is interfering with the urinary tract

Chronic kidney infections in children are sometimes caused by a structural problem that allows urine to flow back from the bladder to kidneys (reflux), or by an inability of the bladder to empty completely
http://www.webmd.com/a-to-z-guides/unde ... ons-basics
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مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 5:09 pm

Urinary Tract Infections

http://www.mayoclinic.org/diseases-cond ... n-20037892
By Mayo Clinic Staff

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.

Women are at greater risk of developing a UTI than men are. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys

Antibiotics are the typical treatment for a UTI. But you can take steps to reduce your chance of getting a UTI in the first place


Symptoms

: Urinary tract infections don't always cause signs and symptoms, but when they do they may include

A strong, persistent urge to urinate
A burning sensation when urinating
Passing frequent, small amounts of urine
Urine that appears cloudy
Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
Strong-smelling urine
Pelvic pain, in women
Rectal pain, in men
UTIs may be overlooked or mistaken for other conditions in older adults

Types of urinary tract infection

Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected

Part of urinary tract affected Signs and symptoms

:(Kidneys (acute pyelonephritis
Upper back and side (flank) pain
High fever
Shaking and chills
Nausea
Vomiting

(Bladder (cystitis
Pelvic pressure
Lower abdomen discomfort
Frequent, painful urination
Blood in urine

(Urethra (urethritis
Burning with urination
When to see a doctor

Contact your doctor if you have signs and symptoms of a UTI


Causes

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out such microscopic invaders, these defenses sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract

The most common UTIs occur mainly in women and affect the bladder and urethra

: (Infection of the bladder (cystitis
This type of UTI is usually caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. Sexual intercourse may lead to cystitis, but you don't have to be sexually active to develop it. All women are at risk of cystitis because of their anatomy — specifically, the short distance from the urethra to the anus and the urethral opening to the bladder

: (Infection of the urethra (urethritis
This type of UTI can occur when GI bacteria spread from the anus to the urethra. Also, because the female urethra is close to the vagina, sexually transmitted infections, such as herpes, gonorrhea and chlamydia, can cause urethritis

Risk factors

: Risk factors for urinary tract infections include

Being female
UTIs are common in women, and many women experience more than one infection. Women have a shorter urethra than men do, which cuts down on the distance that bacteria must travel to reach a woman's bladder

Being sexually active
Sexually active women tend to have more UTIs than do women who aren't sexually active
Using certain types of birth control. Women who use diaphragms for birth control also may be at higher risk, as may women who use spermicidal agents

Completing menopause
After menopause, UTIs may become more common because the lack of estrogen causes changes in the urinary tract that make it more vulnerable to infection

Having urinary tract abnormalities
Babies born with urinary tract abnormalities that don't allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs

Having blockages in the urinary tract
Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTI

Having a suppressed immune system
Diabetes and other diseases that impair the immune system — the body's defense against germs — can increase the risk of UTIs

Using a catheter to urinate
People who can't urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed
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مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 5:16 pm

UTI contd

Complications
When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.

: Complications of UTIs may include

Recurrent infections, especially in women who experience three or more UTIs
Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI, especially in young children
Increased risk of women delivering low birth weight or premature infants


Preparing for your appointment

Your family doctor can treat most urinary tract infections. However, for frequent recurrences or a chronic kidney infection, you'll likely be referred to a doctor who specializes in urinary disorders (urologist) or kidney disorders (nephrologist) for an evaluation.

What you can do

Before your appointment, make a list of medications or supplements you're taking and any allergies you have. This information helps your doctor select the best treatment.

Write down questions to ask your doctor, such as:

What kind of tests do I need?
Can I do anything to prevent a UTI?
What signs and symptoms should I watch out for?
What do the results of my urine test mean?
Do I need to take medicine?
Are there any special instructions for taking the medicine?
What can I do if I keep getting UTIs?
Don't hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, including:

When did you first notice your symptoms?
Have you been treated for a bladder or kidney infection in the past?
How severe is your discomfort?
How often do you urinate?
Are your symptoms relieved by urinating?
Do you have low back pain?
Have you had a fever?
Have you noticed vaginal discharge or blood in your urine?
Are you sexually active?
Do you use contraception? What kind?
Could you be pregnant?
Are you being treated for any other medical conditions?
Have you ever used a catheter?
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مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 5:27 pm

uti contd

Doctors typically use antibiotics to treat urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacterium found in your urine.

Simple infection

: Drugs commonly recommended for simple UTIs include

(Sulfamethoxazole-trimethoprim (Bactrim, Septra, others
(Amoxicillin (Amoxil, Augmentin, others
(Nitrofurantoin (Furadantin, Macrodantin, others
Ampicillin
(Ciprofloxacin (Cipro
(Levofloxacin (Levaquin
Usually, symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics prescribed by your doctor to ensure that the infection is completely gone

For an uncomplicated UTI that occurs when you're otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is adequate to treat your infection depends on your particular symptoms and medical history

Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating. One common side effect of urinary tract analgesics is discolored urine — orange or red.

Frequent infections

: If you experience frequent UTIs, your doctor may make certain treatment recommendations, such as

Longer course of antibiotic treatment or a program with short courses of antibiotics at the start of your urinary symptoms
Home urine tests, in which you dip a test stick into a urine sample, to check for infection
A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity
Vaginal estrogen therapy if you're postmenopausal, to minimize your chance of recurrent UTIs

Severe infection

For a severe UTI, you may need treatment with intravenous antibiotics in a hospital


Home remedies
Urinary tract infections can be painful, but you can take steps to ease your discomfort until antibiotics clear the infection. Follow these tips:

Drink plenty of water to dilute your urine and help flush out bacteria
Avoid drinks that may irritate your bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices and caffeine until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate
Use a heating pad. Apply a warm, but not hot, heating pad to your abdomen to minimize bladder pressure or discomfort
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Re: nephrology

مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 5:41 pm

Kidney infection
By Mayo Clinic Staff
http://www.mayoclinic.org/diseases-cond ... n-20032448


Kidney infection (pyelonephritis) is a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys

A kidney infection requires prompt medical attention. If not treated properly, a kidney infection can permanently damage your kidneys or the bacteria can spread to your bloodstream and cause a life-threatening infection

Kidney infection treatment usually includes antibiotics and often requires hospitalization

Symptoms

: Signs and symptoms of a kidney infection may include

Fever
Back, side (flank) or groin pain
Abdominal pain
Frequent urination
Strong, persistent urge to urinate
Burning sensation or pain when urinating
(Pus or blood in your urine (hematuria


When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you. Also make an appointment if you're being treated for a urinary tract infection, but your signs and symptoms aren't improving

Severe kidney infection can lead to life-threatening complications. Seek immediate medical attention if you experience typical kidney infection symptoms combined with bloody urine or nausea and vomiting


Causes

Kidney infection typically occurs when bacteria enter your urinary tract through the tube that carries urine from your body (urethra) and begin to multiply. Bacteria from an infection elsewhere in your body also can spread through your bloodstream to your kidneys. Kidney infection is unusual through this route, but it can occur in some circumstances — for instance, when a foreign body, such as an artificial joint or heart valve, gets infected. Rarely, kidney infection results after kidney surgery

Complications

: If left untreated, a kidney infection can lead to potentially serious complications, such as

Permanent kidney damage. A kidney infection can lead to permanent kidney damage that causes chronic kidney failure
Blood poisoning (septicemia). Your kidneys filter waste from your blood and then return your blood to the rest of your body. If you have a kidney infection, the bacteria can spread as the kidneys return blood to circulation
Pregnancy complications. Women who develop a kidney infection during pregnancy may have an increased risk of delivering low birth weight babies
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مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 01, 2014 5:46 pm

pyelonephritis contd


Preparing for your appointment


Make an appointment with your family doctor or a general practitioner if you have signs and symptoms of a urinary tract infection. If your doctor suspects your infection has spread to your kidneys, you may be referred to a doctor who treats conditions that affect the urinary tract (urologist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes, including a new sexual partner.
Make a list of all medications, as well as any vitamins or supplements, that you're taking.
Take a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For kidney infection, some basic questions to ask your doctor include:

What is the likely cause of my kidney infection?
What tests do I need?
What treatment do you recommend?
What are the potential side effects of treatment?
Will I be admitted to the hospital?
How will I know whether my kidney infection is cured?
Do you recommend follow-up testing to determine whether the infection has been successfully treated?
How can I prevent kidney infections in the future?
Are there any restrictions that I need to follow?
I have these other health conditions. How can I best manage them together?
Is there a generic alternative to the medicine you're prescribing me?
Are there any brochures or other printed material that I can take with me? What websites do you recommend?
What will determine whether I should plan for a follow-up visit?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:

When did you first begin experiencing symptoms?
Have your symptoms been continuous or occasional?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?


Tests and diagnosis

Your doctor may suspect you have a kidney infection based on your signs and symptoms, such as fever and upper back pain. If your doctor suspects you have kidney infection, you'll likely be asked for a urine sample to determine whether bacteria, blood or pus is in your urine.
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