上海交通大学：《病理生理学》课程教学资源（PPT课件讲稿）第三章 Renal Insufficiency

Renal Insufficiency Ird ld

Renal Insufficiency

To be a great champion you must believe you are the best If you're not, pretend you are.…!” Muhammad ali

“To be a great champion you must believe you are the best. If you’re not, pretend you are….!” – Muhammad Ali

TOPICS Introduction Acute renal failure Chronic renal failure Uremia

TOPICS • Introduction • Acute renal failure • Chronic renal failure • Uremia

Functions of kidney The kidneys are a pair of small organs that lie on either side of your spine at about waist level. They act as filters that keep your blood free of by-products and toxins The kidneys excrete these compounds with water to make urine They also eliminate excess body water while selectively reabsorbing useful chemicals and allowing waste to pass freely into the bladder as urine They allow you to continue to consume a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels

Functions of kidney • The kidneys excrete these compounds with water to make urine. • They also eliminate excess body water while selectively reabsorbing useful chemicals and allowing waste to pass freely into the bladder as urine. • They allow you to continue to consume a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels. The kidneys are a pair of small organs that lie on either side of your spine at about waist level. They act as filters that keep your blood free of by-products and toxins

The kidneys play an essential role in maintaining electrolyte and acid-base balance They produce some hormones including renin prostaglandins, erythropoietin, and active vitamin D So, they are crucial in the regulation of blood pressure, formation of matured red blood cells, and metabolism of calcium and phosphorus

• The kidneys play an essential role in maintaining electrolyte and acid-base balance. • They produce some hormones including renin, prostaglandins, erythropoietin, and active vitamin D. • So, they are crucial in the regulation of blood pressure, formation of matured red blood cells, and metabolism of calcium and phosphorus

Functions of the Kidney Waste excretion Electrolyte balance Fluid balance Osmolality Hormone production

Functions of the Kidney • Waste excretion • Electrolyte balance • Fluid balance • pH • Osmolality • Hormone production

Anatomy of Kidney Nephron

Anatomy of Kidney

NEPHRON STRUCTURE Proximal Glomerulus, Glomerular, Efferent,Afferent involuted capsule arteriole/ arteriole tubule BC Distal TCT convoluted tubule UCI Interlobular vein To renal ein Fror Interlobular ter artery Peritubular sending Nephron loop LOOP OH Collecting Ascending duct HENLE

Manifestation of renal dysfunction o Glomerulus decreased GER glomerular filtration membrane permeability alteration o Renal tubule concentrative function decline(hyposthennuria/isosthenuria water, electrolyte acid-base disorder others o Endocrine disorder hypertension. anemia. renal osteodystrophy others

Manifestation of renal dysfunction Glomerulus · decreased GFR · glomerular filtration membrane permeability alteration Renal tubule · concentrative function decline (hyposthennuria/isosthennuria) · water, electrolyte, acid-base disorder · others Endocrine disorder · hypertension · anemia · renal osteodystrophy · others

体内VtD2的代谢过程 紫外线25-羟化醇 1a-羟化醇 7-影氢胆固醇VtD325(OH)VitD31.25-(oH)2ViD3 (皮肤)(肝微粒体)(肾线粒体)

体内VitD3的代谢过程 紫外线 25-羟化酶 1α-羟化酶 7-脱氢胆固醇 VitD3 25-(OH)VitD3 1,25-(OH) 2VitD3 （皮肤） （肝微粒体） （肾线粒体）