RARE KIDNEY DISEASE
INTRODUCTION TO THE DISORDERS OF THE EXCRETORY SYSTEM
IN hemodialysis
When blood accumulates high concentration of urea due to malfunctioning of kidney, then we term it as uremia. It is very dangerous which may cause different types of kidney problems. In such patients of rare kidney disease, doctor can remove urea by the process of hemodialysis.
Hemodialysis is the process by which large particles separate out from smaller particles through selectively permeable membrane. One of the best devices for dialysis is hemodialysis machine or artificial kidney machine. In hemodialysis, the blood is drained out from a convenient artery like radial artery in rare kidney disease. After that we add anticoagulant like heparin and project to dialyzing unit. The unit contains a coiled cellophane tube surrounded by a dialysing unit. This fluid contains same composition as that of plasma except the nitrogenous waste in rare kidney disease. The porous cellophane membrane of the tube allows the passage the molecules based on concentration gradient. As nitrogenous wastes are absent in the dialyzing fluid, these substances freely move out in rare kidney disease. In this way it clears the blood. Then we pump back the clear blood back in hemodialysis to the body through a vein after adding anti-heparin to it. Hemodialysis becomes boon for thousands of uremic patients with rare kidney disease.
KIDNEY TRANSPLANTATION in hemodialysis
Grafting a kidney from a compatible donor to restore kidney functions in a patient suffering from kidney failure like rare kidney disease which we term as kidney or renal transplantation. It is the ultimate method in the correction of acute renal failures. A functioning kidney is used in transplantation from a donor, preferably a close relative, to minimize its chances of rejection by the immune system of the recipient. Modern clinical methods have increased the success rate of such complicated technique.
There are some more kidney problems in rare kidney disease (hemodialysis) which I discussed below
RENAL CALCULI OR KIDNEY STONE in hemodialysis
These are the insoluble mass of crystallized salts of oxalate formed within the kidney in rare kidney disease. The stones give rise to severe colic pain starting in the back and radiating down to the front of thigh or the testicle or vulva of that side.
PYELENEPHRITIS in hemodialysis: It is an inflammation of renal pelvis, calyces and interstitial tissue. It is usually caused by bacterial infection. The bacteria reach the kidney via urethra and ureter. Inflammation affects the counter current mechanism and the victim fails to concentrate urine in rare kidney disease. The symptoms of this disease include frequent and painful urination, fever and pain in lumber region.
GLOMERULONEPHRITIS or BRIGHT’S DISEASE in hemodialysis:
It is the inflammation of glomerulus as rare kidney disease . It is caused by injury to the kidney, bacterial toxins, drug reaction etc. proteins and RBCs pass out into the filtrate.
CYSTITIS: It is the inflammation of urinary bladder, and is caused by bacterial infection in rare kidney disease. Patient has frequent, painful urination, often with burning sensation.
HYPERTENSION: It is caused by secretion of rennin. Secretion of large amount of renin leads to the formation of angiotension which in turn leads to hypertension.
NOCTURIA: Renal disease in which volume of urine rises so much at night that the person is compelled to wake up to ease out.
NOCTURNAL ENURESIS: Disease of bed wetting during sleep.
POLYURIA: Excretion of an excessive amount of urine.
OLIGOURIA: Deficient urine excretion.
PROTEINURIA: Presence of proteins like albumen, globulin in urine above trace amount.
GLYCOSURIA: Occurrence of glucose in urine.
HEMATURIA : Loss of blood in urine.
KETONURIA: Excretion of ketone bodies in urine.
PYURIA: Passing pus in urine.
VERY SHORT QUESTION ON RARE KIDNEY DISEASE in hemodialysis
Qs1: Name the chordate animal having flame cells as excretory structure.
Ans1: A cephalochordate Amphioxus.
Qs2: Name the cortical portions projecting between the medullary pyramids in the human kidney.
Ans2: Columns of Bertini.
Qs3: Name the loop of kidney running parallel to the Henle’s loop.
Ans3: Vasa recta.
HIGHER ORDER THINKING SKILL ON RARE KIDNEY DISEASE in hemodialysis
Qs4: Terrestrial animals are generally either ureotelic or uricotelic, not ammonotelic, why?
Ans4: Ammonotelic animals excrete ammonia which requires large volume of water to dissolve ammonia and eliminate it from the body. Terrestrial animals cannot afford to lose more water from their body as they live in environment having water scarcity. Therefore, they are ureotelic or uricotelic.
Qs5: What is guano? What is its commercial importance?
Ans5: Guano is a faecal deposition containing b uric acid of marine birds. It is a good fertilizer. It is rich in both nitrogen and phosphorus.
Qs6: How does liver help in excretion in rare kidney disease?
Ans6: Liver is the main organ of urea formation and is also an organ for the excretion of cholesterol, bile pigments, inactivated products of steroid hormones, some vitamins and many drugs. In this way liver releases many harmful and toxic materials from the body.
ANSWER IN BRIEF IN RARE KIDNEY DISEASE in hemodialysis
Qs7: Differentiate between the ascending and descending limbs of Henle’s loop with reference to the permeability to water?
Ans7: Descending limb is permeable to water, but Ascending limb is impermeable to water.
Qs8: What hormone influences reabsorption of water in nephrons?
Ans8: Vasopressin or Antidiuretic hormone (ADH) influences reabsorption of water in nephron.
Qs9: What is the composition of urine of human?
Ans9: Composition of human urea in rare kidney disease
Water, Urea, Ammonia, Creatinine, Hippuric acid, Vitamin C, Oxalic acid, Phenolic substance, Sodium chloride, Phosphates, Sulphates and Chlorides of Ca, K, Mg ions.
Qs10: Why is the color of urine yellow?
Ans10: The yellow color of urine is due to the pigment urochrome derived from breakdown of hemoglobin.
Qs11: What are the accessory excretory organs in rare kidney disease?
Ans11: The organs of the body which, while performing their own specific function also carry out excretion as a secondary activity we term as accessory excretory organs like skin, lungs, liver.
Qs12: What happens to the wall of distal convoluted tubule (DCT) of a nephron when vasopressin is released by the pituitary?
Ans12: On release of vasopressin, the wall of distal convoluted tubule (DCT) becomes permeable.