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Keywords: nephroses, urine, a diuresis, physiopathology of nephroses, a nephron, a pyelonephritis, tubulopatii, a reabsorption, a secretion, a filtration, renal failure, a uremia, an emiction, a uropoiesis, ureters, pelvises, pyelocaliceal system, a pathology

Physiopathology of nephroses. Pathological physiology of renal failure

Key concepts

1. Renal failure (insufficientio renalis) - process of fading of functions of nephroses, one of which basic criteria is sharp downstroke of a glomerular ultrafiltration.
2. the Hyperazotemia productional (hyperazotemia productionis) - rising of the maintenance of an amino nitrogen in a blood plasma as a result of intensifying a catabolism of proteins (a fever, ranevoe an attrition) and infringements of synthesis of a urea in a liver.
3. the Hyperazotemia retentsionnaja (hyperazotemia retentionis) - rising of the maintenance of a filtrate nitrogen (a urea, a creatinine, a urinary acid) in a blood plasma (more than 22 mmole/l), caused by infringement azotovydelitelnoj functions of nephroses.
4. the Isosthenuria (isos - peer, sthenos - force, weight, uron - urine) - the state at which concentration of urine becomes peer osmotic concentration of a blood plasma and testifies to the complete arrest osmotic kontsentrirovanija urine. The maximal osmotic concentration of urine compounds 270-330 mmole/l, and the maximal relative density 1010-1012.
5. the Hyposthenuria (hypo - is lower, sthenos - force, weight, uron - urine) - a state at which the maximal osmotic density of urine is lower, than osmotic concentration of a blood plasma, - reflects a serious lesion kanaltsev nephroses. The maximal osmotic concentration of urine of 200-250 mmole/l, and the maximal relative density - 1005-1008.
6. the Anuria (àn - absence, uron - urine) - a state when in urinary bladder than 50 ml of urine act for a day no more.
7. the Oliguria (oligos - small, uron - urine) - decrease of amount of urine excreted for a day up to 500 ml and less.
8. the Polyuria (polys - much, uron - urine) - augmentation of a daily urine up to 3000 ml and more.
9. the Uremia (uron - urine, haema - a blood, a uremia) - the serious form of renal failure, is characterized by development retentsionnnoj hyperazotemias, a secretory acidosis, an osteodystrophy (" a uremic rachitis " at chronic renal failure).

Educational elements

I. A general etiology and a pathogeny of distresses of functions of nephroses

• - an etiology
• - a pathogeny of infringements of functions of glomuluses and kanaltsev
• infringement of processes of a filtration, an egestion, a reabsorption, a secretion and inkretsii

II. Exhibitings of distresses of renal functions

• - renal signs
• changes of a diuresis
• changes of structure of urine
• - ekstrarenalnye signs and sets of symptoms at diseases of nephroses
• change of structure and physical and chemical properties of a blood
• edemas, an arterial hypertension

III. Pathophysiological mechanisms of distresses of renal functions

• - infringement azotovydelitelnoj functions
• - distress osmo-voljumoregulirujushchej functions
• - infringement vascular tone - distress of an erythrogenesis
• - change of process of coagulation of a blood
• - infringement of an acid-base equilibrium

IV. Distresses of a diuresis

• - neurohumoral mechanisms
• - quantitative changes of a diuresis
• an oliguria and an anuria, mechanisms of development
• a polyuria, mechanisms of development
• - qualitative changes of a diuresis
• a hyposthenuria, an isosthenuria, mechanisms of development

V. Pathological components and physical and chemical properties of urine, " a urinary set of symptoms "

• - a renal parentage
• - ekstrarenalnogo parentages

VI. Change of structure and physical and chemical properties of a blood

• - a hyperazotemia
• - a hypoproteinemia
• - a secretory acidosis: augmentation [H⁺] and downstroke [HCO₃^-]
• - a hyperkalemia
• - a hypocalcemia
• - decrease of the maintenance of erythrocytes and a haemoglobin

VII. Principles of functional research of nephroses

• - concept about clearances - tests of research
• infringements of a glomerular filtration
• infringements of a proximal and distal canalicular reabsorption
• infringements of a canalicular secretion and an egestion
• infringements of a renal blood-groove

VIII. Renal failure, a general characteristic

• - acute (prerenalnaja, renal, prerenal)
• - chronic
• - a uremia

IX. Prerenalnaja the form of acute renal failure

• - an etiology
• - pathophysiological mechanisms of development

X. The renal form of acute renal failure (nephropathy)

• - a diffuse glomerulonephritis: an etiology and mechanisms of development
• - got tubulopatii: an etiology and mechanisms of development
• a nephrotic set of symptoms
• - pathophysiological features of acute renal failure in age aspect
• ancestral tubulopatii (renal enzimopatii)
• - pyelonephrites: an etiology and mechanisms of development

XI. The prerenal form of acute renal failure

• - an etiology
• - pathophysiological mechanisms of development

XII. Chronic renal failure

• - an etiology
• - pathophysiological mechanisms of development

XIII. A uremia: pathophysiological mechanisms of development

XIV. A nephrolithiasis. An etiology, a pathogeny

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Keywords: nephroses, urine, a diuresis, physiopathology of nephroses, a nephron, a pyelonephritis, tubulopatii, a reabsorption, a secretion, a filtration, renal failure, a uremia, an emiction, a uropoiesis, ureters, pelvises, pyelocaliceal system, a pathology

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