Overview of the kidney and kidney diseases

Hello everyone, happy new month. Hope we all are doing okay?.. you are warmly welcome to my post. Today I'll be talking about the Urinary System because The rate at which people (both old and young) are suffering and dieing from Kidney disease and is very much alarming. My motivation behind this post is that I went to Federal Medical Center Umuahia Abịa State Nigeria for ward posting as a Nurse and i found out that the rate at which people die of kidney related disease is very much alarming. Kidney Dialysis is very costly at about 34,000 Naira and it's to be done every week or as instructed by the doctor. However, I'm making this post so that everyone will know about their kidney, location in the body, how urine is produced in the body, diseases of the kidney, how to take care of the kidneys e.t.c..

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The Kidneys are brownish red bean shaped structures about 11cm long, 6cm wide, 3 cm thick and weighs about 150 g. The kidneys is concave in one long side and convex in the opposite.

LOCATION: the human body consist of a pair of kidneys, and the kidney lies on the posterior abdomen (tommy) one to each side of the vertebral column(otherwise known as the spinal cord) and they are below the diaphragm.

The right kidney is slightly lower than the left kidneys because of the considerable space occupied by the liver.

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THE RIGHT KIDNEY
The adrenal gland is ontop of the right kidneys. The right lobe of the liver, and the duodenum are at the front of the right kidney while the diaphragm is behind it.

THE LEFT KIDNEY
At the top of the left kidney, there is an adrenal gland which is responsible for the secretion of hormones. The stomach, pancreas and the colon are at the front of the left kidney while the diaphragm, and some muscles are at the back of the left kidney.

The Kidneys are protected by three coverings (layers of tissues) and these includes:

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1. Anterior Fibrous Capsule which is the first covering

2. The middle cortex which is reddish and is immediately after the fibrous capsule

3. The medulla(renal pyramid) which is the innermost layer of the kidneys.

The hilum is the concave border of the kidneys where blood vessels, lymph vessels, the ureter and nerves enters and leaves the kidneys.
However, urine formed in the kidney passes through a tiny tube the renal papilla at the top of the pyramid and goes into a tube called the the calyces, from the calyces, it flows to the ureter which exit the kidney through the Renal Hilum and enters into the bladder for temporary storage. Urine production is made posible by a little tube called the Nephron.

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The kidneys contains about 1.2milliom nephrons which are tiny tubes that have a collecting duct. The collecting ducts transports urine from the nephron through the pyramid giving the pyramid a striped appearance.
However, the nephron can be said to be the structural and functional unit of the kidneys that ate responsible for urine production.
The nephron is a tube that is closed in one end it contains for parts which are:

• The glomerular capsule (bowman's capsule)

• Proximal convoluted tubule

• Medullary loop of Henle

• Distal convoluted tubules

• Bowman's capsule:- the nephron is indented to form a cup-shaped structure in the closed end called the glomerular capsule(bowman's capsule) which is a network of capillary and it resembles a coiled tuft.

• The proximal convoluted tubule:- this is the part of the nephron that is close to the glomerular capsule.

• The Medullary loop of Henle:- this part of the nephron is close to the proximal convoluted tubule

• Distal convoluted tubule:- this part of the nephron is close to the Medullary loop of Henle and it goes further to form a collecting duct.
  The functions of these parts of the nephron will be discussed when talking about urine production in the human body.

Meanwhile, the collecting ducts unit to form the calyces that goes further to form the ureter that transports urine to bladder for temporary storage.

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The Kidneys forms urine which passes to the bladder for storage before excretion. The composition of urine reflex the exchange of substance between the nephron and the blood in the capillaries. Waste product are excreted, water and electrolytes levels are controlled and PH is maintained by Hydrogen ion.
The afferent arterioles takes blood to the glomerulus for filtration while the efferent arterioles takes the filtered blood through circulation to the heart for oxygenation.
Urine formation includes three steps which are:-

• Glomerular filtration

• Tubular reabsorption

• Tubular secretion

• Glomerular filtration:- The glomerulus serves as a filter and filtration takes place through the semi permeable walls of the glomerulus and the glomerular capsule. What are other small molecule readily pass through the glomerulus and the glomerular capsule of the summary absorbed later. Blood cells, plasma proteins and other land molecules are too large to filter through and therefore remain in the capillaries. Glomerular filtration is a non-selective passive process in which fluid passes from the blood into the capsule and the fluid is called filtrate. Filtration takes place because there is a difference between the blood pressure in the glomerulus and the blood pressure of filtrate in the glomerular capsule. A hydrostatic pressure of about 7.3 KB (kilopascal) build up in the glomerulus because the efferent arterioles is narrower than the afferent arteriole and this pressure is opposed by cosmetic pressure of the blood provided mainly by proteins of about 4 kPa (kilopascal can) and future is hydrostatic pressure of about 2 kPa (kilopascal) in the glomerular capsule.

• Glomerular Filtration Rate
  This can be defined as the total amount of urine(filtrate) formed by the two kidneys kidneys in a minute. In a healthy adult the glomerular filtration rate is about 125 ml/mils per minute

• Auto Regulation
  This can be defined as a situation in which renal blood flow and glomerular filtration is protected. It is a process whereby renal blood flow is maintained at a constant pressure across a wide range of 6 to leak blood pressure from 80 to 200 mmHg.

• Tubular/selective reabsorption:- beside waste and excess ions, the filtrate contains many useful substance including water, glucose, qmino acid, and ions which must be reclaimed from the filtrate and returned to the blood. Tubular reabsorption begins as soon as the filtrate enters into the proximal convoluted tubules. However this is a process whereby the cells in the tubules automatically take up useful substances from the filtered urine and send them back to the blood by osmosis so that it can be used by the body.
  This process takes place in the medullary loop of Henle.

• Tubular secretion: this occurs as filtrate flow from the glomerulus. Substance such as hydrogen, potassium, ions and creatinine also moves from the blood to the peritubular capillaries through the tubular cells or from the tubular cells themselves into the filtrate to eliminate as urine. This is an important process of urine formation where by substance that are not needed in the body are eliminated through urine examples of such substances are creatinine, excess potassium some drugs like aspirin penicillin.
  This process takes place in the distal convoluted tubule.

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Urine is clear and Amber in colour due to the presence of urobilin (a by-pigment altered in the intestine). The specific gravity of urine is about 1020 to 1030 and the pH is around around 6 (normal range of the pH is 4.8 to 8) . A healthy adult passes from 1000 to 1500mils of urine per day. Urine is composed of water (96%) urea (2%) creatinine, uric acid, ammonia sodium and potassium (2%) chloride phosphate sulphate and oxalate (2%).
"Specific gravity "is a term used to compare the evidence of heaviness of urine and distilled water.

The kidneys have the following functions;

1. Formation of urine

2. Maintaining water, electrolyte and acid balance

3. Excretion of waste products

4. Production and excretion of erythropoietin (the hormone that stimulates the function of red blood cells)

5. Production and secretion of renin (an important enzyme in the blood pressure)

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Kidney disease are caused by a variety of bacterial and fungal infection, toxins like tobacco and these can lead to kidney failure. Kidney failure can be caused when the body is loaded with excess toxins. Some of the kidney disease are:-

• Kidney stones

• Urinary tract infection (UTI)

• Glomerular Nephritis

• Polycystic kidney

• Kidney stones
  Kidney stones is a common kidney problem that occurs when electrolytes, ions, water etcétera becomes in a cristalised form in the kidneys, forming solid stone-like masses in the kidneys. These stones however makes the kidney pit more effort in urine formation, thereby stressing the kidneys and making the stones visible while urinating.

• Glomerulonephritis
  Glomerulonephritis is an inflamation of the cup-shaped structure that filters urine called the bowman's capsule. This disease is caused by infections, disorders that occur inutero(in the womb) or shortly after birth, and drugs.it often gets better on its own but it is very vital to see a physician.

• Polycystic kidney
  Polycystic kidney is a genetic disorder that causes plenty cysts to start growing in the kidneys. This growth interferes with the normal functioning of the kidneys and in extreme cases, results to kidney failure.

• Urinary tract infection
  These are bacterial infections that affects the urinary system( the kidney, bladder, urethra, ureter). I'm extreme cases, this infection migrate to the kidneys and bring about kidney failure.

In our day to day life's there are somethings that we do that affects the kidneys like:-b

1. Delay in using the restroom when pressed: once the bladder is filled, it needs to be emptied. If left filled, the urine in the bladder makes it easy for bacteria to multiply, making it possible for UTI.

2. Excess intake of salt

3. Excess intake of protein

4. Caffeine:- Caffeine raises an individuals blood pressure, making the workload for not only the kidney but the entire body high. However, it is adviced to reduce the amount of coke, coffee, tobacco an individual takes daily.

5. Lack of water:- the kidneys needs water in other to carryout it's activities.. without water, the kidney tends to shrink in size, making the lumen(opening) of the tubules reduce in size. If left for a long time without water, there will be renal failure.

6. Lack of medical checkup:- it is important for an individual to check their kidneys regularly to know how they are. also, an individual should treat underlying sickness so that it'll not migrate to other parts of the body.

7. Lack of knowledge:- it is important for an individual to have a knowledge of their health in general. Its very vital to know what's inside our body so that we'll at least be able to provide first aid care for ourselves or others before going to the hospital.

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KKidney disease can go unnoticed for a long time until symptoms starts showing up, that's why the need for regular medical check up will help notice and treat this sickness immediately. The following are some early signs and symptoms one will see:

• fatigue

• Poor concentration

• Difficulty falling asleep

• lose appetite

• Abdominal muscles pains

• Oedema

• puffy eyes when the individual wakes

-dry skin

• frequent urination..most especially during nights

In severe cases:

• vomiting

• nausea

• loss of appetite

• concentrated urine

• fluid retention

• anemia

• rise in potassium level

• pericardial inflammation

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There are varioud ways to prevent kidney diseases, some of which are:

• Manage your stress

• Make exercise part of your activities of daily living

• Stop smoking

• Maintain a good and healthy weight

• Check blood pressure

• Regular check of blood sugar

• Eat healthy and balanced meal

• Reduced intake of caffeine

• Get enough rest and sleep

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When an individual is diagnosed of kidney disease, that's not the end of the world as there are therapies that can help to manage this disease and they include:-

• constant check of blood pressure to determine wether it's high or low or normal

• Kidney dialysis as instructed bythe doctor

• monitor kidney health by knowing the amount of fluid intake and fluid output

• less intake of salt

• intake of fluid with nutrients

• less intake ot protein for individuals that are not malnourished

• take medications as prescribed by the physician without missing a dose

• always make sure that weight is at the healthy state

• enough rest and sleep will help

• smoking should be stopped as well as caffeine intake

• reduced stress

Thank you for your time in reading this post, i hope you at least got some knowledge about how your kidneys looks like, how they function and how to prevent diseases of the kidneys. If you find this post interesting, follow me for more interesting posts and If this is your first time to come across my post, you can know more about me.

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