Pyelonephritis

Phonetic exercise: urine [‘juərin], urinary [‘juərinri], excretory [eks’kri:təri], ureters [juə‘ri:təz], urethra [juə‘ri:θrə], abdomen [‘æbdəmen], abdominal [æb’dminl], diaphragm [‘daiəfræm], urination [,juə‘ri’nei∫n], nephritis [ni’fraitis], pyelonephritis [,paiələni’fraitis], renal failure [‘ri:nl ‘feiljə], urethritis [,juəri:θ’raitis], abnormalities [,æbn:‘mælətiz], hyperplasia [,haipə‘plei∫iə]

Make a report on pyelonephritis according to the plan below:

Definition: an ascending urinary tract infection that has reached the pelvis of the kidney, a form of nephritis.

Causes: bowel organisms that enter the urinary tract: E. coli (70-80%) and Enterococcus faecalis; coliforms and enterococci, etc.

Risk factors: any structural abnormalities to the kidneys and the urinary tract, kidney stones, urinary tract catheterisation, urinary tract stents or drainage procedures (e.g. nephrostomy), pregnancy, neurogenic bladder (e.g. due to spinal cord damage or multiple sclerosis) and prostate disease (e.g. benign prostatic hyperplasia) in men; diabetes mellitus, immunocompromised states; positive family history (close family members with frequent urinary tract infections), etc.

Epidemiology: Pyelonephritis is very common, with 12-13 cases annually per 10,000 population in women and 3-4 cases per 10,000 in men. Young women are most likely to be affected, traditionally reflecting sexual activity in that age group. Infants and the elderly are also at increased risk, reflecting anatomical abnormalities and hormonal status.

Symptoms, signs, clinical manifestations, clinical features: dysuria (painful voiding of urine), abdominal pain (radiating to the back on the affected side) and tenderness of the bladder area and the side of the involved kidney (costovertebral angle tenderness), fever, rigors (violent shivering while the temperature rises), headache, and vomiting, delirium in severe cases; sepsis, a systemic response to infection characterized by fever, a raised heart rate, rapid breathing and decreased blood pressure (occasionally leading to septic shock).

Diagnosis: culture of the urine; blood cultures; X-rays of the kidneys, ureters and bladder (KUB); ultrasound of the kidneys, voiding cystourethrography, etc.

Treatment: antibiotics as therapy, and treatment of any underlying causes to prevent recurrence; nutritional approaches: increasing fluid intake, consuming cranberry juice, blueberry juice, and fermented milk products containing probiotic bacteria, etc.

Renal failure

Phonetic exercise: urine [‘juərin], urinary [‘juərinri], excretory [eks’kri:təri], ureters [juə‘ri:təz], urethra [juə‘ri:θrə], failure [‘feilə], urination [,juə‘ri’nei∫n], renal failure [‘ri:nl ‘feiljə], acute [ə‘kju:t], chronic [‘kr nik], adequately [‘ædikwətli], injury [’ind3əri], diabetes [,daiə’bi:ti:z], urea [‘juəri;ə], nocturnal [nk’tə:nl], urination [,juəri‘nei∫n], excess [ik’ses], hyperplasia [,haipə‘plei∫iə], accidents [‘æksidənts], injury [‘ind3əri], supply [sə‘plai], approximately [ə‘prksimətli], damage [‘dæmid3], pressure [‘pre∫ə], intravenous [,intrə‘vi:nəs], dialysis [dai’æləsis], transplant [træn’spla:nt, trn’spla:nt]

Make a report on renal failure according to the plan below:

Definition: a situation in which the kidneys fail to function adequately.

Classification: two forms of renal failure: acute (acute kidney injury) and chronic (chronic kidney disease).

Causes of acute kidney failure: the result of a sudden interruption in the blood supply to the kidney, or as a result of a toxic overload of the kidneys. Some causes of acute failure: accidents, injuries or complications from surgery where the kidneys are deprived of normal blood flow for an extended period of time, heart-bypass surgery, drug overdoses, whether accidental or from chemical overloads of drugs such as antibiotics or chemotherapy, etc.

Causes of chronic kidney disease: diabetes mellitus, long-standing, uncontrolled, hypertension, polycystic kidney disease, overuse of some common drugs, such as aspirin, ibuprofen, codeine and acetaminophen, etc.

Epidemiology: Acute kidney injury is common among hospitalized patients. It affects some 3-7% of patients admitted to the hospital and approximately 25-30% of patients in the intensive care unit.

In Canada, 1.9 to 2.3 million people have chronic kidney disease. UK estimates suggest that 8.8% of the population of Great Britain and Northern Ireland have symptomatic CKD.

Symptoms, signs, clinical manifestations, clinical features: no symptoms; but if the kidney failure continues then symptoms will become noticeable; symptoms of kidney failure: high levels of urea in the blood; vomiting and/or diarrhea, which may lead to dehydration; nausea; weight loss; nocturnal urination; foamy or bubbly urine; more frequent urination, or in greater amounts than usual, with pale urine; less frequent urination, or in smaller amounts than usual, with dark coloured urine; blood in the urine; pressure, or difficulty urinating; itching; bone damage; muscle cramps (caused by low levels of calcium which can cause hypocalcaemia); a build up of potassium in the blood that diseased kidneys cannot filter out (called hyperkalemia): abnormal heart rhythms, muscle paralysis; failure of kidneys to remove excess fluid may cause: swelling of the legs, ankles, feet, face and/or hands, shortness of breath due to extra fluid on the lungs (may also be caused by anemia), polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver: pain in the back or side; feeling tired and/or weak, memory problems, difficulty concentrating, dizziness, low blood pressure; other symptoms: appetite loss, a bad taste in the mouth, difficulty sleeping, darkening of the skin, etc.

Treatment of acute kidney failure: avoidance of substances that are toxic to the kidneys, called nephrotoxins; monitoring of renal function, urinary catheters; specific therapies: intravenous fluids, steroid medications, nephrostomy or urinary catheter, diuretics, renal replacement therapy, etc.

Treatment of chronic kidney failure: control of blood pressure and treatment of the original disease; angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs); replacement therapy: in the form of either dialysis or a transplant; dietary modifications, etc.

Kidney transplantation or renal transplantation: the organ transplant of a kidney into a patient with end-stage renal disease.