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- [Instructor] Like any system,

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the urinary system also
has several disorders.

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One of the probably most
well-known ones is kidney stones.

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Now, kidney stones can
come in various amounts.

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Could be large, could be small,

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there could be various causes.

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But they all share the same idea.

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All kidney stones are
crystallized minerals.

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Some mineral is starting
to form this structure.

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This structure will cause
a blockage of urine flow.

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Urinary tract infections, known as UTIs.

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A lot of times they're based
on bacterial infections.

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Now if we go back to the
beginning of the chapter,

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we remember that mentioned the urethra,

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the part of the system
that allows urine to flow

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from the urinary bladder out of the body,

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is longer in men and shorter in women.

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This shorter urethra in women allows for

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it to be more common to have
UTIs in the female system.

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Due to the fact that
the urethra is shorter,

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it makes it a shorter path,

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a faster pathway,

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to get back up into the system

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to cause an infection.

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Now UTIs pretty routinely can be treated,

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no problem there.

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But if left untreated,

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a person doesn't want
to go to the doctors,

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or doesn't know what's
going on or whatever,

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the bacterial infection can actually

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go from the urinary bladder

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all the way up the
ureters into the kidneys.

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If a bacterial infection hits
the inside of the kidneys,

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now we're talking about
some serious problems.

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Acute renal failure.

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Well that doesn't sound very good.

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The reason is, it's not very good.

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It's short-term impairment
of functionality.

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That means the urinary system
is not working properly.

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If it's not working, your
blood is not getting filtered.

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So you can have acute renal failure,

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and it can be completely
reversible, thankfully.

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The trick is to figure out what's going on

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and try to fix it.

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So we have potential causes.

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Low blood pressure,
sustained low blood pressure,

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not just it went down for five minutes.

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Could have some large kidney stones

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that block the flow of
urine from the kidneys.

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Could be an infection.

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Transfusion reactions.

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What that means is you
had a blood transfusion

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and unfortunately something
wasn't working right,

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your body started to
reject the transfusion.

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Severe injury, trauma could cause it.

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Toxins, drugs.

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There's numerous things

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that could cause acute renal failure.

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But acute being short
term, chronic is long term.

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In chronic renal failure,

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a lot of times also known
as end stage renal disease,

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a lot here now we have disorders
that are ending in this.

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That might start as something else,

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and then go into renal failure.

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For example, Type I diabetes.

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Not everyone that has Type I diabetes

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will end up with chronic renal failure,

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but about 40% of people
that have Type I diabetes

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end up going into renal failure.

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Now what this is being looked at,

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is the fact that more than 60%

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of the nephrons in the
kidneys are not functioning.

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Well what are the causes?

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All the same as acute.

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But it just means that it's
more of a long-term aspect now,

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it's not being reversed.

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So how do you treat kidney failures?

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If it's irreversible,
dialysis is one option.

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In dialysis, which is the picture here,

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the person has their blood
being removed from the body,

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put through this dialysis
machine to help clear it out,

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clear out what shouldn't be there,

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and then it puts the
blood back into the body.

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So really that machine is working

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as the function of a kidney.

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We also have kidney transplants.

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Now kidney transplants
can be a little complex.

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With a kidney transplant,
it all depends on,

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can you find a donor?

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Can you find a kidney that
will match your unique system?

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Matching all the antigens,
matching all your cell markers.

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So it's not as simple as, "Oh
I want a kidney, found one."

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No, you have to find the match,
go through all these tests.

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Now we have this CAPD,

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continuous ambulatory peritoneal dialysis.

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Now there are some advantages

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and some disadvantages to this.

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Advantages, you don't have
to go to a dialysis center.

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This is done right at home.

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What ends up happening is,

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instead of a dialysis machine,

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it uses your peritoneal cavity

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for the waste and ion removal.

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Now the peritoneal cavity is the cavity

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where you have your
intestines, your stomach,

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your abdominal cavity.

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There are membranes in there that

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will act like a filtering system.

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Problem is, there's a
greater risk of infection

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with continues ambulatory
peritoneal dialysis.

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It's also not quite as efficient,

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so it's constantly going

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and running and running in your body.

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So we have dialysis at a dialysis center,

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then we have this continuous
ambulatory peritoneal dialysis.

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A little more convenient, but
there's also downsides to it.

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So you have to kind of take
the benefits and the risks

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and see which one is
more appropriate for you.

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Hemodialysis.

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Now hemodialysis, a lot
of times you're having

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several visits a week
to a dialysis center.

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The blood is heading
through a kidney machine

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that basically functions as a kidney.

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So we have hemodialysis.

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Can be two, three visits,

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I've heard up to five
times visiting per week.

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But dialysis isn't totally foolproof.

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Dialysis can never completely
maintain homeostasis.

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It helps to clear out the excess ions,

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clear out the excess waste,

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but it's not as efficient as a kidney.

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Plus it doesn't really
replace the renal hormones.

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It's a machine that is meant to clean,

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it's not meant to be a
hormone-producing machine.

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So you have that erythropoietin,

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that was the hormone that kidneys produce,

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to increase red blood cell production.

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A dialysis machine can't do that.

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Now I mentioned before about
kidney transplants, briefly,

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but this is a great solution
if a person can find a donor.

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So really it's the best hope,

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because you take this
kidney out of the system

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that's not working, and
replace it with a kidney

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that is fully functional.

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Problem is, it's hard to find a match.

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You can't simply go to a list and say,

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"Oh there's a match
right there, let's go."

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No, you have to match
the cell surface markers,

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match the blood typing,
match the antigens,

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there's tons of things that need to match.

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But if you can find a match, that's great.

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The problem is, right now, give or take,

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there's over 65,000 people on
a waiting list for kidneys.

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That just goes to show you
how many people need a kidney,

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but how hard it is to find
a match or find donors.

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So it's not a simple and quick easy fix.

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It's very complicated, but if it works,

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it's a great solution for the patient,

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for the recipient.

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Now there's been a ton
of improvements lately.

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They have better
tissue-matching techniques.

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What that means is,
there's a less or lower

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chance of having a renal rejection.

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So by matching the tissues more closely

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to what the patient's
or recipient's body is,

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gives a higher percentage
chance of it working.

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They have better
anti-rejection medications.

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Now any organ transplant,

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whether it's kidney or anything else,

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the recipient is going to have

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these anti-rejection medications.

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What they're meant to
do is help to suppress

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the recipient's immune system.

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Give the body a chance
to get the new organ in,

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and acclimate the organ,

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before the body's full
immune system kicks in.

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So it's trying to give it a better chance.

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Then you have these national data banks.

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Before there was only regional,

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where if you lived in New York,

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you had to find a kidney
within that region,

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in the North East.

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Now it's nation wide.

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There could be a kidney
coming from California

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heading all the way up to Maine.

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So this information
technology is also aiding out,

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helping out with better
matching techniques.