Introduction:-
The excretory system is a critical component of human physiology, responsible for removing waste products and maintaining homeostasis. Disorders of this system can have profound effects on overall health, leading to a range of symptoms and complications. These disorders can involve the kidneys, ureters, bladder, and urethra, each playing a specific role in excretion.
Uremia:-
Uremia is a serious medical condition that arises when the kidneys fail to filter waste products from the blood effectively. This condition is often a consequence of advanced chronic kidney disease (CKD) or acute kidney injury (AKI). When the kidneys’ filtering capacity diminishes, waste products, especially urea, and other toxins accumulate in the bloodstream, leading to uremia.
Symptoms:-
The common symptoms of uremia are as follows:-
Fatigue and weakness: Due to the buildup of toxins and anemia, which often accompanies kidney failure.
Loss of appetite: A common issue leading to malnutrition and weight loss.
Itching (pruritus): Toxins in the blood can cause severe itching.
Swelling (edema): Due to fluid retention, particularly in the legs, ankles, and around the eyes.
Confusion and difficulty concentrating: As toxins affect the central nervous system, leading to cognitive impairments.
Muscle cramps and twitching: Resulting from electrolyte imbalances.
Shortness of breath: Due to fluid buildup in the lungs or anemia.
Treatment:
Treatment of uremia is as follows:-
Dialysis: A procedure that artificially removes waste products and excess fluid from the blood. There are two main types: hemodialysis and peritoneal dialysis.
Medications: To manage symptoms and complications such as high blood pressure, anemia, and electrolyte imbalances.
Dietary modifications: Reducing protein intake to lower urea production, and managing fluid and electrolyte intake.
Kidney transplant: In cases of end-stage renal disease, a kidney transplant may be considered as a long-term solution.
Haemodialysis:-
Haemodialysis is a life-sustaining treatment for individuals with end-stage renal disease (ESRD) or severe acute kidney injury (AKI) when the kidneys can no longer perform their vital function of filtering waste products and excess fluids from the blood. This medical procedure artificially removes these wastes, helping to maintain a balance of electrolytes and fluids in the body.
Procedure:
Hemodialysis involves circulating the patient’s blood through a machine known as a dialyzer or artificial kidney. The process typically takes place in a dialysis center, hospital, or at home, and is generally performed three times a week, with each session lasting about four hours.
Vascular Access:-
Arteriovenous (AV) Fistula: This is the preferred type of access, created surgically by connecting an artery to a vein, usually in the arm. It allows for high blood flow, which is essential for effective dialysis.
AV Graft: If a fistula is not feasible, a synthetic tube is used to connect an artery and vein.
Central Venous Catheter: For short-term or emergency access, a catheter is placed in a large vein, often in the neck, chest, or leg.
Dialyzer Function:
Blood flows from the body into the dialyzer, where it passes through thin, semi-permeable membranes.
A special dialysate fluid on the other side of the membranes draws out waste products and excess fluids via diffusion and osmosis.
Clean blood is then returned to the body.
Lifestyle Adjustments:-
Patients undergoing hemodialysis must adhere to specific lifestyle changes, including:
Diet: Restricting sodium, potassium, and phosphorus intake, and managing fluid consumption to prevent overload.
Medications: Taking prescribed medications to control blood pressure, anemia, and bone health.
Regular Monitoring: Frequent blood tests to monitor kidney function, electrolyte levels, and overall health.
Disorder of the Excretory System
Kidney Transplantation:-
Kidney transplantation is a surgical procedure performed to replace a failing or failed kidney with a healthy kidney from a living or deceased donor. This treatment is often the best option for patients with end-stage renal disease (ESRD), offering improved quality of life and survival rates compared to dialysis.
Procedure:-
The transplantation process involves several steps:
Evaluation and Listing:
Comprehensive Assessment: Patients undergo a thorough medical evaluation to determine their suitability for transplantation. This includes blood tests, imaging studies, and assessments of heart and lung function.
Waiting List: Suitable candidates are placed on a transplant waiting list managed by national or regional organizations. The wait time can vary based on factors like blood type, tissue match, and urgency.
Finding a Donor:
Living Donors: A kidney can be donated by a living person, often a family member or close friend, who has a compatible blood and tissue type.
Deceased Donors: Kidneys from deceased donors are matched to recipients based on compatibility and urgency.
Surgery:
Recipient Preparation: The recipient is prepared for surgery with anesthesia and preoperative medications.
Transplantation: The donor kidney is surgically placed into the recipient’s lower abdomen. The blood vessels of the donor kidney are connected to the recipient’s blood vessels, and the ureter (urine tube) is connected to the bladder.
Postoperative Care:-
Immunosuppressive Therapy: To prevent the body from rejecting the new kidney, recipients must take immunosuppressive medications for life.
Monitoring: Regular follow-ups and monitoring are essential to ensure the kidney is functioning well and to detect any signs of rejection or complications.
Benefits:
Improved Quality of Life: Recipients often experience greater energy levels, improved physical function, and a more unrestricted diet compared to life on dialysis.
Increased Survival Rates: Transplant recipients generally have better long-term survival rates than patients who remain on dialysis.
Freedom from Dialysis: Transplantation eliminates the need for regular dialysis sessions, offering more freedom and flexibility
Renal calcull :- Stone or insoluble mass of crystallized salts (oxalates etc) formed within the kidney..
Glomerulonephritis:- Inflammation of glomeruli of kidney.
Note:-
Inulin is a fructan storage polysaccharide It is not metabolised in human body and is aready filtered through kidneys. It is therefore used in testing kidney function, especially glomerular filtration rate.
Tubular maxima:- The maximum amount of substance that can be retained in blood and beyond which it will be excreted in urine. It is also called renal threshold value, for glucose it is 180mg/100 ml of blood.
