Diabetes
Sally Robinson in Priorities for Health Promotion and Public Health, 2021
The combination of high blood glucose and high blood pressure can damage the main renal artery as well as the tiny blood vessels inside the kidneys, which interferes with the filtration process. Useful substances, such as water and protein, are not fullysaved and waste products may not be properly excreted, so we feel unwell. Signs of kidney damage are protein in the urineblood in the urineswollen ankles, feet and handsfeeling tired, short of breath and nauseous(Diabetes UK, 2020c)
The patient with acute renal problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
The renal system has a crucial role to play in maintaining homoeostasis. The primary function of the kidneys is to produce urine as a waste product that can then be excreted from the body by the accessory renal organs, the ureters, the urinary bladder and the urethra. This is a complex physiological process, because, as the blood plasma is filtered through the kidneys, many adjustments are made to the water and solute levels in order to maintain a dynamic equilibrium within the body. Renal impairment, from a primary or secondary cause, or a systemic illness, such as sepsis, can quickly lead to life-threatening complications. Nurses have a key role to play in the prevention of acute renal injury in all patients (but particularly those most at risk) and in the early recognition and assessment of renal problems. Nurses must also effectively plan, implement and evaluate all interventions for those individuals with established renal dysfunction, liaising effectively with other members of the multidisciplinary team in the provision of quality care.
Fundamentals
Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam in Introduction to Computational Health Informatics, 2019
Kidneys are bean-shaped organs on either side of the body. The kidney is made of millions of tiny filters called nephrons. Kidneys are located below the rib cage behind the belly and are connected to the blood-vessels. Kidneys filter out excess undesired fluid and water-soluble chemicals into the blood. The filtered blood goes to heart for oxygenation, while the unsought fluid is excreted as urine through a bladder – a funnel-shaped sack used to keep urine before drainage. Urine contains many chemicals not required by the body. Two major components of urine are urea and ammonium. Kidneys are essential for electrolyte balance, regulation of ion concentration, pH level balance, blood pressure management, water level balancing and production of many hormones. They also regulate extracellular fluid volume and ensure enough plasma to keep blood flowing to vital organs. Two important biomarkers excreted by a kidney are creatinine and blood urea nitrogen (BUN). Kidneys are adversely affected by diabetes, high blood pressure and heart disease.
Incidence and risk factors for recurrent focal segmental glomerulosclerosis after kidney transplantation: a meta-analysis
Published in Renal Failure, 2023
Jiang Bai, Tianxiang Zhang, Yan Wang, Jiajing Cao, Zihui Duan, Linghui Ji, Yun Zhou, Chuan Hao, Qiang Guo
No curative therapies exist for the treatment of FSGS, and a significant proportion (40–70%) of patients with FSGS advance to kidney failure within 10–20 years after diagnosis, making FSGS one of the most common primary glomerular diseases leading to kidney failure requiring dialysis, along with diseases such as diabetic nephropathy and hypertensive nephrosclerosis [8,9]. In cases of kidney failure, kidney transplantation is usually the therapy of choice. However, primary FSGS recurrence occurs in 40%–60% of patients after kidney transplantation and varies widely depending on the study population, diagnostic criteria, and follow-up duration [10]. Patients with FSGS recurrence have a 52 percent 5-year graft survival rate compared to 83 percent in patients without FSGS recurrence, which significantly impairs the quality of life and places a heavy burden on families [10].
Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial
Published in Annals of Medicine, 2022
Yin-Chin Wang, Ming-Jiuh Wang, Chih-Yuan Lee, Chien-Chia Chen, Ching-Tang Chiu, Anne Chao, Wing-Sum Chan, Meng-Kun Tsai, Yu-Chang Yeh
End-stage kidney disease remains a global health concern; patients undergoing dialysis experience a lower quality of life and suffer increased morbidity and mortality. Kidney transplantation is the definitive treatment for patients on dialysis. However, ischemia-reperfusion injury to the transplanted kidneys may affect their postoperative function after kidney transplantation [1,2]. Moreover, renal microcirculation is a key issue related to acute and chronic kidney diseases [3]. Renal microvascular dysfunction includes alterations in endothelial barrier permeability, exaggerated inflammation, and impairment of endothelium-dependent vasorelaxation [3]. Our previous study revealed the alteration of sublingual microcirculatory dysfunction in patients on dialysis, and the severity of this alteration was lower in patients who receive a kidney transplant [4]. Surgical stress may affect the pre-existing microcirculatory dysfunction of patients undergoing kidney transplantation.
Urinary proteomics for kidney dysfunction: insights and trends
Published in Expert Review of Proteomics, 2021
A kidney transplant is performed to replace a diseased kidney (often ESKD) with a healthy kidney from a deceased or living organ donor. Unfortunately, graft injury can occur due to a multitude of factors, including ischemia reperfusion injury, cell or antibody-mediated rejection, infections or toxicity from immunosuppressive drugs. Early detection of graft injury is key to maintaining long-term graft function, but this usually is assessed by kidney biopsy subsequent to alterations in serum creatinine when renal function is already declined [57]. In principle, urinary proteomics has the potential as a noninvasive diagnostic technique to determine graft injury [58]. In one recent study, two-dimensional (2D) LC-MS/MS and isobaric Tags for Relative and Absolute Quantitation (iTRAQ) were used to analyze differences in the urinary proteome of patients with a stable kidney allograft, or those with acute kidney rejection, BK viral nephropathy or chronic allograft nephropathy [59]. A panel of 35 proteins were identified that had the ability to segregate the 3 major transplant injury clinical groups from stable allographs, providing a basis for developing a urinary biomarker panel to detect specific kidney injuries before alterations in other clinical parameters.
Related Knowledge Centers
- Bladder
- Body Fluid
- Renal Artery
- Urine
- Ureter
- Renal Vein
- Mammalian Kidney
- Retroperitoneal Space
- Acid–Base Homeostasis
- Electrolyte