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oThis is a powerful compensatory mechanism, but it cannot typicallycompensate for systolic blood pressures below 70 mm Hg. Pressures ator below that level result in a decreased GFRCannot filter blood if systolic BP is below 70The hormones antidiuretic hormone (ADH) and aldosteroneocontrol the permeability of the DCT membrane. Antidiuretic hormone,also known as vasopressin, is discussed in detail later regarding thekidneys’ role in the regulation of water balanceANTIdiuretic to retain urineoAldosterone is a hormone secreted from the adrenal cortexthat increases the reabsorption of sodiumin the DCT. Becausewater follows sodium, the reabsorption of water is also increasedoA serum glucose over 220 mg/dL results in incomplete reabsorptionand resulting glycosuria.
Hormonal FunctionReninoRenin aids inblood pressure regulation within the body. It isproduced and released when receptors in the kidneys sense adecrease in blood flow, volume, or pressureoRenin interacts with angiotensinogen released from the liverto produce angiotensin I,which,with the aid of angiotensin-converting enzyme (ACE) secreted from the lungs, results inthe formation of angiotensin II.Angiotensin II constricts bloodvessels, resulting in increased blood pressureErythropoietinoErythropoietin is ahormone produced exclusively by the kidneysinresponse to decreased renal blood flow and hypoxiaoErythropoietin stimulates the bone marrow to produce RBCsPotential Nephrotoxic SubstancesoVancomycin (Vancocin)oNonsteroidal anti-inflammatory drugs (NSAIDs, e.g., aspirin, ibuprofen)oSalicylatesoACE inhibitorsoBenzodiazepinesoLithium (Lithobid)oContrast mediaAnuriaois atotal urine output ofless than 100 mL in 24 hoursOliguriaodecreased amount of urineoutput,100 to 400 mL in 24 hoursPolyuriaodescribesexcess quantities of urine outputRenal and Urinary System Assessment AbnormalitiesAnuriaoLess than 100-mL urine output/24 hrEnd-stage renal disease, acute renal failure, urinary tractobstructionDysuriaoDifficulty or pain with urinationUrinary tract infection, cystitis (bladder infection)HematuriaoPresence of blood in the urineCystitis or other inflammation in the urinary tract, calculi,cancers of the urinary tract, renal disease, bleeding disorders,medications such as anticoagulants
OliguriaoDecreased urine output; less than 400-mL urine output/24 hrShock, end-stage renal disease, acute kidney injury, severedehydration, blood transfusion reactionPercussionopatient reports pain or tenderness, it is suggestive of kidneyinflammation or infectionBlood TestoThe most utilized blood tests include serum creatinine, BUN, andBUN/creatinine ratiooElectrolyte values including sodium,potassium, phosphorus, andcalciumare also monitored as a reflection of kidney function.

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Term
Spring
Professor
NoProfessor
Tags
Hematology, Bone marrow

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