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Kidney Failure

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ID: ANM11017
MEDICAL ANIMATION TRANSCRIPT: The kidneys are located on either side of the spinal column in the posterior abdominal cavity behind the peritoneum in the retroperitoneal space. The functions of each kidney include filtration of metabolic wastes, fluids, and electrolytes from the blood during urine production, stimulation of red blood cell production, and regulation of blood pressure. The medullary pyramid and outer cortex compose the renal lobe, the structural unit of the kidney. Branches of the renal artery supply each renal lobe. The functional unit of the kidney is the nephron, composed of the renal corpuscle and the renal tubule. The renal corpuscle is where initial blood filtration occurs. It consists of a spherical network of capillaries called the glomerulus enclosed by a cup-shaped structure called Bowman's capsule. The size difference between the afferent arteriole and the efferent arteriole of the glomerulus creates the pressure that forces glomerular filtrate into Bowman's capsule. Reabsorption of water and other substances occurs in the renal tubule. Ninety-nine percent of the glomerular filtrate is reabsorbed as it passes through the parts of the renal tubule, including the proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct. Acute renal failure is the sudden loss of the kidney's ability to remove waste and concentrate urine. Prerenal acute renal failure causes include anything that compromises blood flow to the kidneys, such as hemorrhage or hypotension. Singularly or together, reduced blood pressure and reduced blood volume at the glomerulus result in less filtrate moving into Bowman's capsule. Intrarenal acute renal failure results from damage to nephrons. Toxins and lack of oxygen to kidney tissues can damage the nephron. Postrenal acute renal failure is associated with urinary tract obstructions such as kidney stones. Treatment for acute renal failure depends on the cause. Maintaining blood fluid volume, hemodialysis, or surgical removal of kidney tract obstructions may be required. Chronic renal failure is the loss of kidney function over a period of years. Nephron function is lost as a result of systemic diseases such as hypertension and diabetes mellitus or kidney diseases such as chronic glomerulonephritis. Treatments include dietary control, including fluid restrictions, medication for the underlying condition, and electrolyte modifiers, ACE inhibitors for hypertension, and insulin therapy or hemodialysis can reduce chronic renal failure. End-stage renal failure usually requires dialysis and kidney transplantation.
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