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  • Diabetic Nephropathy: Regional Morbidity: Ten (10) Leading Causes

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    Marielle Chua
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    The document discusses diabetic nephropathy, which is a progressive kidney disease associated with diabetes that can lead to end-stage renal disease. It notes that diabetes accounts for 30-50% of end-stage kidney disease cases in developed countries. The document also provides an overview of the anatomy and physiology of the urinary system, including the structures of the kidney, nephron, and processes of urine formation through glomerular filtration, tubular reabsorption and secretion.

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    TOPIC-1-NCM-112

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    The document discusses diabetic nephropathy, which is a progressive kidney disease associated with diabetes that can lead to end-stage renal disease. It notes that diabetes accounts for 30-50% of end-stage kidney disease cases in developed countries. The document also provides an overview of the anatomy and physiology of the urinary system, including the structures of the kidney, nephron, and processes of urine formation through glomerular filtration, tubular reabsorption and secretion.

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    118 views3 pages

    Diabetic Nephropathy: Regional Morbidity: Ten (10) Leading Causes

    Uploaded by

    Marielle Chua
    The document discusses diabetic nephropathy, which is a progressive kidney disease associated with diabetes that can lead to end-stage renal disease. It notes that diabetes accounts for 30-50% of end-stage kidney disease cases in developed countries. The document also provides an overview of the anatomy and physiology of the urinary system, including the structures of the kidney, nephron, and processes of urine formation through glomerular filtration, tubular reabsorption and secretion.

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    of 3

    CARE OF CLIENTS WITH PROBLEMS IN FLUID AND dialysis, or transplantation.

    Data combined
    ELECTROLYTES, ACUTE AND CHRONIC
    from different sources show that more than 1.5
    DIABETIC NEPHROPATHY million people worldwide are on RRT, 80% of
    whom live in Japan, Europe, and North
     is a progressive kidney disease associated America.
    with diabetes mellitus – type 1 and type 2 –  Kidney diseases, especially End Stage Renal
    affecting kidney glomeruli, arterioles, tubules Diseases (ESRD), are already the 7th leading
    and the interstitium. cause of death among the Filipinos. One Filipino
    develops chronic renal failure every hour or
    about 120 Filipinos per million population per
    year. More than 5,000 Filipino patients are
    presently undergoing dialysis and
    approximately 1.1 million people worldwide
    are on renal replacement therapy.
     In the past, Chronic Glomerulonephritis (CGN)
    was the most common cause of chronic renal
    failure.
     Today, diabetes mellitus and hypertension
    have taken center stage in the causation of ESRD
    which together account for almost 60% of dialysis
    patient.

    REGIONAL MORBIDITY: TEN (10)


     Clinical features include macroalbuminuria LEADING CAUSES
    and a reduction in glomerular filtration rate that
    may lead to end-stage renal disease, requiring Number & Rate/100,000 Population*
    dialysis or kidney transplantation. Philippines, 2016 – SOCCSKSARGEN
     Estimates of the global burden of disease
    indicate that diseases of the kidney and urinary 1. Acute Respiratory Infection
    tract account for approximately 830,000 2. Hypertension
    deaths and 18,467,000 disability-adjusted life 3. Pneumonia
    years annually, ranking them 12th among 4. Acute Watery Diarrhea
    causes of death (1.4% of all deaths) and 17th 5. Influenza
    among causes of disability (1.0% of all 6. Acute Hemorrhagic Fever
    disability-adjusted life years). This ranking is 7. Urinary Tract Infection
    similar across world bank regions. 8. Dengue Fever
     According to the National Kidney Foundation 9. Typhoid Fever
    in an American journal published last 2018, 10. Diseases of the heart
    diabetic kidney disease and diabetic nephropathy
    ANATOMY AND PHYSIOLOGY OF THE
    are the leading cause of end-stage kidney disease
    (ESKD) in the United States and most developed URINARY SYSTEM
    countries. Diabetes accounts for 30% to 50 % of
    the incident cases of ESKD in United States. Organs of the Urinary System:
     Generally, renal diseases progress to a final 1. Kidneys
    stage as End-Stage Renal Disease (ESRD) and 2. Ureters
    function is substituted by Renal Replacement 3. Urinary Bladder
    Therapy (RRT), hemodialysis, peritoneal 4. Urethra
    NEPHRON URINE FORMATION
     the functional unit of the kidney The three steps of formation of urine by the kidneys
     each kidney has approx. 1.3 million nephrons are:
     is composed of glomerulus and renal tubules 1. Glomerular Filtration
     primary function is formation of urine 2. Tubular Reabsorption
    3. Tubular Secretion

    GLOMERULUS
     Is a tuft of semi-permeable capillaries,
    surrounded by the Browman’s capsule.
    GLOMERULAR FILTRATION
    RENAL TUBULES
     Movement of
    THREE REGIONS OF THE RENAL water and solutes
    TUBULES from the blood to
    the glomerular
    1. PROXIMAL CONVOLUTED TUBULES capsule.
    2. LOOP OF HENLE  The fluid that
    enters the capsule
    3. DISTAL CONVOLUTED TUBULES is glomerular
    filtrate.

    TUBULAR REABSORPTION
     It is the
    movement of
    substances from
     About 1,200 ml of blood flows to the kidneys the filtrate in
    per minute, which is 20-25% of the cardiac the kidney
    output. tubules into the
     The normal Glomerular Filtration Rate (GFR) blood in the
    is 125 ml/min. peritubular
     From this, the kidneys form 0.5 to 1 ml of capillaries.
    urine per minute, thereby 30 to 60 ml per hour or  Only 1% of the filtrate remains in the tubules
    approximately 1,500 ml per day. and become urine.
     250 – 450 ml of urine in the bladder triggers  Water and other substances that are useful to
    micturition reflex. the body are reabsorbed.
     Water is reabsorbed by osmosis, while most
    solutes are reabsorbed by active transport.
    TUBULAR SECRETION
     It is the transport of
    substances from the
    blood into the renal
    tubules.

    MICTURITION
     It is the act of expelling urine from the bladder
    (also urination or voiding).

    FUNCTIONS OF URINARY SYSTEM


    1. Urine formation
    2. Excretion of waste products
    3. Regulation of electrolytes
    4. Regulation of acid-base balance
    5. Control of water balance
    6. Control of blood pressure (Renin)
    7. Regulation of red blood cell production
    (Erythropoietin)
    8. Synthesis of vitamin D to active form

    ERYTHROPOIETIN (EPO)
     is a hormone produced by the kidney that
    promotes the formation of red blood cells by the
    bone marrow.

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