- [Instructor] Like any system,
the urinary system also has several disorders.
One of the probably most well-known ones is kidney stones.
Now, kidney stones can come in various amounts.
Could be large, could be small,
there could be various causes.
But they all share the same idea.
All kidney stones are crystallized minerals.
Some mineral is starting to form this structure.
This structure will cause a blockage of urine flow.
Urinary tract infections, known as UTIs.
A lot of times they're based on bacterial infections.
Now if we go back to the beginning of the chapter,
we remember that mentioned the urethra,
the part of the system that allows urine to flow
from the urinary bladder out of the body,
is longer in men and shorter in women.
This shorter urethra in women allows for
it to be more common to have UTIs in the female system.
Due to the fact that the urethra is shorter,
it makes it a shorter path,
a faster pathway,
to get back up into the system
to cause an infection.
Now UTIs pretty routinely can be treated,
no problem there.
But if left untreated,
a person doesn't want to go to the doctors,
or doesn't know what's going on or whatever,
the bacterial infection can actually
go from the urinary bladder
all the way up the ureters into the kidneys.
If a bacterial infection hits the inside of the kidneys,
now we're talking about some serious problems.
Acute renal failure.
Well that doesn't sound very good.
The reason is, it's not very good.
It's short-term impairment of functionality.
That means the urinary system is not working properly.
If it's not working, your blood is not getting filtered.
So you can have acute renal failure,
and it can be completely reversible, thankfully.
The trick is to figure out what's going on
and try to fix it.
So we have potential causes.
Low blood pressure, sustained low blood pressure,
not just it went down for five minutes.
Could have some large kidney stones
that block the flow of urine from the kidneys.
Could be an infection.
Transfusion reactions.
What that means is you had a blood transfusion
and unfortunately something wasn't working right,
your body started to reject the transfusion.
Severe injury, trauma could cause it.
Toxins, drugs.
There's numerous things
that could cause acute renal failure.
But acute being short term, chronic is long term.
In chronic renal failure,
a lot of times also known as end stage renal disease,
a lot here now we have disorders that are ending in this.
That might start as something else,
and then go into renal failure.
For example, Type I diabetes.
Not everyone that has Type I diabetes
will end up with chronic renal failure,
but about 40% of people that have Type I diabetes
end up going into renal failure.
Now what this is being looked at,
is the fact that more than 60%
of the nephrons in the kidneys are not functioning.
Well what are the causes?
All the same as acute.
But it just means that it's more of a long-term aspect now,
it's not being reversed.
So how do you treat kidney failures?
If it's irreversible, dialysis is one option.
In dialysis, which is the picture here,
the person has their blood being removed from the body,
put through this dialysis machine to help clear it out,
clear out what shouldn't be there,
and then it puts the blood back into the body.
So really that machine is working
as the function of a kidney.
We also have kidney transplants.
Now kidney transplants can be a little complex.
With a kidney transplant, it all depends on,
can you find a donor?
Can you find a kidney that will match your unique system?
Matching all the antigens, matching all your cell markers.
So it's not as simple as, "Oh I want a kidney, found one."
No, you have to find the match, go through all these tests.
Now we have this CAPD,
continuous ambulatory peritoneal dialysis.
Now there are some advantages
and some disadvantages to this.
Advantages, you don't have to go to a dialysis center.
This is done right at home.
What ends up happening is,
instead of a dialysis machine,
it uses your peritoneal cavity
for the waste and ion removal.
Now the peritoneal cavity is the cavity
where you have your intestines, your stomach,
your abdominal cavity.
There are membranes in there that
will act like a filtering system.
Problem is, there's a greater risk of infection
with continues ambulatory peritoneal dialysis.
It's also not quite as efficient,
so it's constantly going
and running and running in your body.
So we have dialysis at a dialysis center,
then we have this continuous ambulatory peritoneal dialysis.
A little more convenient, but there's also downsides to it.
So you have to kind of take the benefits and the risks
and see which one is more appropriate for you.
Hemodialysis.
Now hemodialysis, a lot of times you're having
several visits a week to a dialysis center.
The blood is heading through a kidney machine
that basically functions as a kidney.
So we have hemodialysis.
Can be two, three visits,
I've heard up to five times visiting per week.
But dialysis isn't totally foolproof.
Dialysis can never completely maintain homeostasis.
It helps to clear out the excess ions,
clear out the excess waste,
but it's not as efficient as a kidney.
Plus it doesn't really replace the renal hormones.
It's a machine that is meant to clean,
it's not meant to be a hormone-producing machine.
So you have that erythropoietin,
that was the hormone that kidneys produce,
to increase red blood cell production.
A dialysis machine can't do that.
Now I mentioned before about kidney transplants, briefly,
but this is a great solution if a person can find a donor.
So really it's the best hope,
because you take this kidney out of the system
that's not working, and replace it with a kidney
that is fully functional.
Problem is, it's hard to find a match.
You can't simply go to a list and say,
"Oh there's a match right there, let's go."
No, you have to match the cell surface markers,
match the blood typing, match the antigens,
there's tons of things that need to match.
But if you can find a match, that's great.
The problem is, right now, give or take,
there's over 65,000 people on a waiting list for kidneys.
That just goes to show you how many people need a kidney,
but how hard it is to find a match or find donors.
So it's not a simple and quick easy fix.
It's very complicated, but if it works,
it's a great solution for the patient,
for the recipient.
Now there's been a ton of improvements lately.
They have better tissue-matching techniques.
What that means is, there's a less or lower
chance of having a renal rejection.
So by matching the tissues more closely
to what the patient's or recipient's body is,
gives a higher percentage chance of it working.
They have better anti-rejection medications.
Now any organ transplant,
whether it's kidney or anything else,
the recipient is going to have
these anti-rejection medications.
What they're meant to do is help to suppress
the recipient's immune system.
Give the body a chance to get the new organ in,
and acclimate the organ,
before the body's full immune system kicks in.
So it's trying to give it a better chance.
Then you have these national data banks.
Before there was only regional,
where if you lived in New York,
you had to find a kidney within that region,
in the North East.
Now it's nation wide.
There could be a kidney coming from California
heading all the way up to Maine.
So this information technology is also aiding out,
helping out with better matching techniques.