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There are a lot of reasons that disrupt kidney function. By origin, they are classified into primary [hereditary, congenital (enzymopathies, tubulopathies, nephropathies, kidney developmental abnormalities)] and secondary (acquired) - infectious and non-infectious [oncological, post-traumatic, immuno-allergic, satellite (concomitant)]; both are exogenous and endogenous. According to the level of action, they are divided into prerenal, renal and postrenal.

I. The main prerenal causes include:

1. Neuropsychiatric disorders (stress, mental trauma, neurosis, impaired innervation of the kidneys),

2. Endocrinopathies (Itsenko-Cushing's disease / syndrome, hyperaldosteronism, hypo- or hyperthyroidism, arterial hypertension),

3. Circulatory system disorders [vascular tone disorder (arterial hypertension and hypotension), venous hyperemia, changes in the mass of circulating blood, heart failure, and others].

II. Renal causes include:

Directly damaging kidneys [infectious and infectious-allergic diseases of the kidneys and extrarenal origin (nephritis, pyelonephritis, diffuse glomerulonephritis, sepsis, cholera, dysentery, etc.), injuries, toxins, including nephrotoxins (mercury, cadmium, uranium), tumor growth ],

2. Violations of the intrarenal circulation (thrombosis, embolism, atherosclerosis, etc.),

3. Damaging the genome and / or program for its implementation in nephrocytes (free radicals, lipid hydroperoxides, viruses).

III. Postrenal causes include:

1. Congenital and acquired abnormalities of the kidneys (hypoplasia, polycystic and other hereditary defects),

2. Factors that interfere with the outflow of urine [calculi in the urinary tract, inflammation of the ureters, bladder, urethra, tumors of the urinary tract or neighboring organs (eg, prostate), ureteral inflection, etc.].

So, nephropathy is formed when (1) glomerular filtration, (2) reabsorption, and (3) secretion are disturbed.
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  1. Impaired renal concentration function
    Violations of the concentration ability of the kidneys under various conditions (thirst, water load) and with changes in plasma osmolarity are manifested by hypostenuria, isostenuria and astenuria. Hypostenuria - restriction of the concentration ability of the kidneys with different osmolarity of urine (from maximum to minimum). In this case, the specific gravity of urine can reach 1.025, and the osmolarity of urine is 850 mmol / l.
    Urination is due to three successive processes - filtration, reabsorption, secretion. Clinically impaired renal function is primarily manifested by a change in the daily amount of urine and its composition. Violation of diuresis. In a healthy person, daily diuresis ranges from 1-1.5 liters. With pathology, there are changes in the amount of urine, the rhythm of its formation and frequency
    Frederik L. Coe (Frederik L. Soy) Azotemia, Oliguria and Anuria Azotemia Serum urea and creatinine concentrations are often used to assess glomerular filtration rate (GFR). Both of these substances are formed respectively in the liver and muscles at a fairly constant rate. As noted in Ch. 218, they are completely filtered in glomeruli and are not reabsorbed in
  4. The effect of anesthesia on the body with impaired renal function
    Elimination of most drugs used during anesthesia depends entirely or partially on renal excretion. Impaired renal function requires dose adjustment to avoid the accumulation (cumulation) of the drug or its active metabolites. In addition, azotemia potentiates the effects of many drugs. This effect of azotemia may be due to reduced
    Dysfunctions of the kidneys and electrolyte
  6. Kidney function assessment
    An accurate assessment of kidney function is based on laboratory data (Table 32-1). Kidney damage may be due to glomerular and / or tubule dysfunction, as well as urinary obstruction. Since glomerular dysfunction has the most severe consequences and is relatively easy to detect, laboratory tests have been widely used to determine the speed
  7. Methods for the study of renal function.
    Studying the functional state of the kidneys in their pathology is no less important than determining the nosological form of the disease. In nephrological practice, both total (for example, nitrogen excretion) and partial (glomerular filtration, tubular reabsorption and secretion) kidney functions are investigated. The methods used for this make it possible to determine the state of each function and judge
  8. Study of osmoregulatory kidney function
    The study is based on the ability of the kidneys to osmotically concentrate and dilute urine. These processes depend on the effective operation of nephrons, general hemodynamics, which determine the rheology of blood, renal blood flow, neurohumoral regulation, and other factors. Violation of any link leads to impaired renal function. Zimnitsky test Based on a study of the relative density in individual
  9. Effect of surgery and anesthesia on kidney function
    Surgery in all cases is accompanied by regular changes in kidney function. These changes, on the one hand, are caused by the action of an operating injury, and on the other hand, by the effect on the kidneys of the means and methods of pain relief. The main factor determining renal dysfunction during surgery and anesthesia is surgical trauma. Operating injury violates
  10. Kidney function assessment
    Since the kidneys are the main organ that releases nitrogen-containing waste, the concentration of blood urea nitrogen (AMA) and creatinine characterizes their function. The significant variability of urine output and the ability of the tubules to absorb filtered urine make the study of AMA less reliable than the study of creatinine for this purpose. In general, we can assume that after acute
  11. Endocrine Renal Function
    The main substance that forms in the epithelioid cells of the juxtaglomerular apparatus and has hormonal activity is renin. It plays the role of a key component of the renin-angiotensin-aldosterone system, which ensures physiological regulation of blood pressure. Renin is essential in the genesis of arterial hypertension. Influenced by Angiotensin
  12. Kidney function
    N.V. Ozerova Kidneys play a very important role in the processes of maintaining the constancy of the water-electrolyte balance of the body and the removal of toxic products. This is achieved due to the functioning of the following systems: - system "renin - angiotensin - aldosterone". The kidneys secrete renin in response to tissue hypoperfusion, hyperhydration (a decrease in the concentration of sodium ions) and an increase in sympathetic
  13. The structure and function of the kidneys
    On the section of the kidney it is clearly seen that immediately under the thin connective tissue capsule is a moderately dense Scheme 18.1. The structure of the nephron is a cortical substance (0.7-0.8 cm thick), and below it is the cerebral substance, represented by pyramids. The parenchyma of the cortical and medulla in one kidney is 1 - 1.5 million structural and functional units of the organ - nephrons. Every nephron has
  14. Brain functions and possible violations of these functions
    Higher brain functions include speech, gnosis and praxis. The speech function is closely related to the functions of writing and reading. Several analyzers, such as visual, auditory, motor, and kinesthetic, take part in their implementation. For the correct performance of the function of speech, it is necessary to preserve the innervation of the muscles, primarily the tongue, larynx, soft palate. Also significant
  15. Nutrition for kidney diseases with preserved nitrogen excretion function
    If the nitrogen-secreting function of the kidneys is preserved, nutrition is recommended, the main purpose of which is to sparing the kidney by restricting in the diet primarily foods that are rich in extractive substances, as well as excluding from it fried and spicy dishes, smoked meats, various seasonings, legumes, cauliflower, radish , sorrel, green salad, onions, garlic, celery,
  16. Dysfunction of the nervous system caused by a hereditary metabolic disorder
    Disorders of the nervous system during congenital metabolic disorders arise as a result of the influence of several factors: • direct damage to nerve cells due to an enzyme deficiency; • accumulation of certain unsplit metabolic products in the outside of the cell fluid; • damage to other organs (eg, liver); • damage to cerebral vessels.
  17. Violation of the function of the tubules
    The allocation of disorders associated with dysfunction of the tubules is conditional, since the tubular kidney system is functionally closely related to the glomeruli, and pathological disorders more often follow the dysfunction of the nephron as a whole, but some indicators can be considered as the result of a primary dysfunction of the tubules. Such disorders include
  18. Violation of the function. PAIN
    CAUSAL-INVESTIGATIVE COMMUNICATION In accordance with the conditioned reflex teaching I.P. Pavlova (15) and the theory of functional systems P.K. Anokhin (2.19), a function occurs in response to the influence of environmental factors. Traumatic environmental factors cause pain impulses in nociceptive fibers. (23). Given that the compression of nerve fibers can be not only in the reception area, but also in any
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