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Nephrology

 Medical study of physiology and treatment of diseases of the kidneys.

a couple linked in a loving dance of filtration

KIDNEY FUNCTIONS: The kidneys are well known for cleaning the blood of waste & toxins that result from metabolism.  The Kidneys are also in charge of balancing bodily fluids, regulating blood pressure and the release of certain hormones. The two kidneys filter over 120 quarts of blood daily & produce between 1 - 2 quarts of urine. The kidneys are also responsible for the production of an active form of vitamin D & regulation of red blood cells.  

BUN -  BLOOD UREA NITROGEN

The Kidneys remove Urea (a waste produced as an outcome of  protein synthesis) from the blood. The BUN test shows how well the kidneys are functioning.  If your BUN level is high, your kidneys are not removing urea from the blood normally. Having this test done on a regular bases, helps keep your kidneys on track. 

Prevention and Wellness 

 

Elevated BUN levels indicate:

 

  • A diet high in protein.

  • Congestive heart failure, shock, vomiting, diarrhea with dehydration, which can result from Prerenal azotemia (decreased blood to the kidneys).

  • Postrenal azotemia (dysfunction due to blockage to the ureters and bladder which can result in or due to bilateral ureteral obstruction; bladder outlet obstruction; bladder dysfunction; multiple sclerosis; spinal cord injury, and diabetes.  

 

Low Bun levels indicate:

  • Malnutrition.

  • Fluid overload which can lead to edema.

  • Pregnancy.

  • Syndrome of inappropriate Antidiuretic Hormone

  • Liver disease or damage.

  • Haemodailysis.

  • A low protein diet.

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      THE NEPHRON          
A practical assembly in the kidney, consisting of a bundle of nerve endings, spores, or small blood vessels and its tubules, through which liquid passes before its classification as urine.  There are more one million nephrons in each kidney.
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In Each Nephron:
A glomerulus is a bundle of nerve endings, spores, and small blood vessels that filter the blood.  Other wise known as a tuft, the cluster of capillaries are located at the first stages of a nephron's activities. The tuft maintains its form with surrounding smooth intraglomerular mesangial cells. The Glomerulus contains The mesangium which is a structure that accompanies the capillaries; is outside the capillary opening, and  is surrounded by capillaries. The glomerular capillaries deposit through efferent arterioles, which are specialized to produce strong hydrostatic pressure to insure proper filtration. The basement membrane, surrounds both mesangium and capillaries. The basement membrane is an environment that adjusts cellular behaviors to moderate tissue function, repair, and development.
 Enzymatic conversion of Vitamin D
Vitamin D is transported through the bloodstream to the liver. There it is modified into the prohormone calcifediol.  The kidneys then further hydroxylate calcifediol  to produce  calcitriol, the biologically active form of vitamin D.  This active form of vitamin D regulates the concentration of calcium and phosphate in the body promoting healthy bone growth.  Calcitriol also has effects on the  immune functions, inflammation reduction, cellular growth, and neuromuscular activities. .
The  basement membranes serve as storage of growth activities, and is a barrier that structurally supports and separates tissues. During morphogenesis  (when an organism develops into its shape.), tissues often join together, and distinct physiological changes in basement membranes occur to manage the transportation or exchange of cells. Specific molecular activities control the creation of passages in basement membranes that allow the direct access to cells between tissues. 
  Mesangial cells make up more than  35% of the total cells in the glomerulus. They are phagocytic, and are separated by endothelial cells from capillary lumina.
 The main role of mesangial cells is to dispose of compartmentalized residues, and aggregated protein (which is mis-folded proteins clumping together.)  from the basement membrane. The filtrate goes through  further various filtration from Bowman's capsule, which cups the glomerulus to the nephon's renal tubule. Filtered through the glomerulus, is liquid known as tubular fluid. The Bowman capsule collects fluids from the blood in the glomerulus; and extracts waste, excess water, and salts. Once it has gone through the renal tubule, the filtrate is sent to the collecting duct system.
 
The renal tubule is composed of the following:
  • Proximal convoluted tubule: which helps with absorption.
  • Loop of Henle: U shaped with two main stages -
    Descending  limb of loop of Henle: sodium chloride does not easly pass through,        urea can moderatly pass through while water is easily reabsorbed by osmosis;              here the filtrate is dramaticaly concentrated into urine.
    Ascending limb of loop of Henle: A continuation of the descending limb, after the        sharp bend of the loop.  The Ascending limb of loop of Henle sends the fluid                downstream as it drains the urine into the distal convoluted tubule.
  1.    Thin Ascending limb of loop of Henle: Impermeable to water but will allow        chloride through
  2.   Thick Ascending limb of loop of Henle: reabsorbs sodium chloride                        potassium, calcium, and magnesium.  
  •   Distal convoluted tubule:  Regulates potassium, sodium, calcium, and pH levels.
  •   Connecting tubule: encourages the regulation of water and electrolytes,      including sodium, and chloride.
  •   Cortical collecting duct:  a series of tubules connecting nephrons to the renal pelvis. The collecting duct system helps balance electrolytes and fluids by reabsorption and excretion; and processes regulated by the hormones.  
  •   Renal pelvis:  An outlet for urine flowing to the ureter.
The End

​Signs of an over-worked Kidney 

  1. High blood pressure.

  2. Low blood pressure.

  3. Blood and/or protein in the urine.

  4. Creatinine and Blood Urea Nitrogen (BUN) blood test, with abnormal levels. 

  5. A glomerular filtration rate (GFR) below normal levels. 

  6. More frequent urination, particularly at night; uncomfortable urination.

  7. Swelling of hands and feet, and around the eyes.

  8. Calcium deposits on skin

  9. Dizziness, Fatigue, Hormone irregularity 

  10. Obesity

Is this back pain or kidney pain?
Your Nephrologist can let you know, and you can take proactive steps to insure the best path for the health of your kidneys.
The heart, and kidneys are very dependent on each other. Maintaining the health of both can automatically increases ones vitality of the senses, body, and brain functions. Blood pressure and sugar levels are also easily balanced; while the immune system and bone transformations can occur effortlessly. Call today for an appointment :  718 284 7070 
To truly honor the kidneys, we can remember that it effects the entire circulatory system,
 
A 32 year man was referred to a Nephrologist due of high blood pressure and decreasing eye sight. After testing and treatment the man regained control of his blood pressure and his eye sight.   
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A 48 year old woman came in with depression and fatigue, during her physical it was found that she had low blood pressure after consulting with the Nephrologist, she balanced her blood pressure, her diet, and feels revitalized.
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A 27 year old dialysis patient was reducing treatments, Once he reviewed the new treatment plan with his Nephrologist, he was able to adjust his levels gently and successfully.

MED CARE CONSULTANTS

718 284 7070

WHEN IT COMES TO YOUR KIDNEYS, WE GOT YOUR BACK.

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