Secretion of Ions to Maintain Acid-Base balance:Moves ions from the blood into the urine. Kidneys regulate the balance between bicarbonate and carbonic acid by secretion nd exchange of hydrogen ions for sodium ionsoExcretion:Eliminate unwanted substances through urineoRenal Control of Cardiac Output and Systemic Blood:Alter the resistance to blood flow both at the beginning of the glomerulus and at the endoCalcium, Phosphorus, and Vitamin D:Kidneys produce the active for of vitamin D (calcitriol) which regulates the absorption of Calcium and phosphorus and assists in the levels of both in the bloodoErythropoietin:Kidneys produce a hormone called erythropoietin (stimulates the maturation of red blood cells in bone marrow)Kidney Disease Causes:oTrauma, infections, birth defects, medications, chronic disease (atherosclerosis, diabetes, hypertension), Toxic metal consumption, and errors in genetic code.oDiabetic nephropathy is the most common cause of renal failureoMyocardial infraction or an extensive burn can precipitate renal disease by decreasing the perfusion of the kidney or increasing its metabolismAfter a heart attack: blood flow to the myocardium is decreased, impairing myocardial function, then less blood is delivered to the tissue. Kidneys sense the decrease in cardiac output and try to compensate by reabsorption of water which leads to fluid overload and edema.oCatabolism causes an increase in nitrogenous products and potassium, which must be excreted, but then over works the kidneysoThe three common conditions increase the risk of renal disease:ObesityPoorly controlled diabetesHypertension oLosing weight helps reduce diabetes and hypertension, which help reduce kidney disease chancesoNormalization of blood glucose and lipid levels along with blood pressure decrease the risk of renal diseaseoA1C level of 7% should be the target oHypertension accelerates the progression of diabetic nephropathyGlomerulonephritis:oNephritis: inflammation of the kidneys (most common type of kidney disease)oGlomerulonephritis is inflammation of the glomerulus (often follows scarlet fever or strep throat)oSymptoms include:NauseaVomitingFeverHypertensionEdemaBlood in urine (hematuria)Decreased output of urine (oliguria)Protein in the urine (proteinuria) Anuria (no urine output)oRecovery can be complete, but some can go into the chronic stage (progressive loss of kidney function).Specific Tubular Abnormalities:oA structural problem in the renal tubules may result in abnormal reabsorption by the tubulesoCan result in ineffective cleansing of the bloodNephrotic syndrome:oDamage to the glomeruli capillary walls which permit the passage of albumin into the glomerular filtrate. The water and sodium are retained. Edema can be so severe it masks the tissue wasting.