Anemia elevated blood urea nitrogen retention bun and

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, anemia, elevated blood urea nitrogen retention (BUN ) and serum creatinine , oliguria, sodium, and water retention (w/ consequent hypertension and some localized edema), and, sometimes, congestive heart failure is typical; numerous hyaline and granular casts are generally seen on UA; the actual RBC casts are regarded as highly suggestive of this syndrome; acute glomerulonephritis is often related to recent infection by group A beta hemolytic streptococci ; it is theorized that circulating immune complexes trigger a strong inflammatory response in the glomerular basement membrane, resulting in a direct injury to the glomerulus itself; other possible causes include drug related exposures , acute kidney infections due to other bacterial (and possibly viral ) agents, and other systemic immune complex diseases , such as systemic lupus erythematosus (SLE) and bacterial endocarditis CHRONIC GLOMERULONEPHRITIS --- lethal glomerular inflammation may lead to glomerular scarring and the eventual loss of functioning nephrons ; this process often goes undetected for lengthy periods b/c only slight proteinuria and hematuria are observed; gradual development of uremia (or azotemia, excess nitrogen compounds in the blood) may be 1 st signs of this process NEPHROTIC SYNDROME --- can be caused by several diff diseases that result in injury and increased permeability of the glomerular basement membrane ; this defect almost always yields several abnormal findings, such massive proteinuria (>3.5 g/day) and resultant hypoalbuminemia ; the subsequent decreased plasma oncotic pressure causes a generalized edema as a result of the movement of body fluids out of the vascular and into the interstitial spaces; other hallmarks of this syndrome are hyperlipidemia and lipiduria ; lipiduria takes the form of oval fat bodies in the urine ; these bodies are
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RENAL FUNCTION OBJECTIVES degenerated renal tubular cells containing reabsorbed lipoproteins ; primary causes are associated directly w/ glomerular disease states KIDNEY STONES --- (also called renal calculi ) formed by the combination of various crystallized substances , and of theses calcium oxalate stones are by far the most commonly encountered; it is currently believed that the recurrence of calculi in susceptible individuals is a result of several causes but mainly a reduced urine flow rate (related to reduced fluid intake) and saturation of the urine w/ large amnts of essentially insoluble substances ; chemical analysis of stones is important in determining the cause of the condition; specialized x-ray diffraction and infared spectroscopy techniques are widely used for this purpose; chemical symptoms are, of course, similar to those encountered in other obstructive processes: hematuria , urinary tract infections , and characteristic abdominal pain 4. Explain the therapy of chronic renal failure with regard to renal dialysis and transplantation.
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