Week 4 Alterations in Renal and Urinary Function:
Obstruction-
- Urinary calculi (stones) are a common cause of functional urinary obstruction
o There are many other causes
o Strictures within the urinary tract may c
...
Week 4 Alterations in Renal and Urinary Function:
Obstruction-
- Urinary calculi (stones) are a common cause of functional urinary obstruction
o There are many other causes
o Strictures within the urinary tract may create an anatomical obstruction
- Complete obstructions must be addressed quickly to prevent backflow of urine into the pressure
sensitive kidney because it can result in permanent renal dysfunction
- Partial obstructions often result in inflammation and infection and must be treated to prevent progression
to a complete obstruction
(See Pic of causes of urine obstruction below)
Urinary Tract Obstruction and Hydronephrosis:
Renal calculi-
- The specific cause of renal calculi is unknown but a number of risk factors have been identified
o Men are more than double as likely as women to develop kidney stones
lOMoAR cPSD|25270114
o People who secrete high concentrations of Ca, Mg, ammonium, phosphate, uric acid, or cystine
in the urine are at an increased risk
o The pH of urine can also increase the likelihood of stone formation with
▪ A low pH increases risk of forming a uric acid stone
▪ A high pH increases risk of forming a Ca or phosphate stone
- Calcium stones account for 70-80% of all renal calculi
The actual formation of kidney stone can be simulated by placing a supersaturated salt solution in a glass as the
water evaporates the salt begins to precipitate into a solid.
- A similar process occurs in the urine as it becomes supersaturated with various salts that precipitate and
then being to solidify into calculi
- Precipitate and stones less than 5mm are often passed thru the urinary tract with normal micturition
- Larger stones may not be able to pass or may create a partial or complete urinary tract obstruction with
subsequent flank pain and N and V
- If stones are 1cm or larger they have little to no probability of passing spontaneously
- The APN may prescribe pain meds to relieve discomfort caused by renal calcul
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