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Kidneys
Ureters
Urinary bladder
Urethra
Regions of the Kidney
Renal cortex
outer region
Renal medulla
inside the cortex
Renal pelvis
inner collecting
tube
Kidney Structures
Filtration
Reabsorption
Secretion
Filtration
Gagal Ginjal
Ginjal kehilangan kemampuan
mempertahankan volume dan kompartemen
cairan tubuh pada diet normal
Bakteriuria
Bakteri >= 10 5 /ml urin
80% krn E. coli
Faktor predisposisi
Obstruksi aliran kemih
Sex, wanita > pria
Umur
Kehamilan
Refluks vesiko-ureter
Kateterisasi
Peny. Ginjal
Gg. Metabolik ( diabetes, gout)
Glomerulonefritis
Nyeri
Nyeri pinggang, kolik ureter
Hematuria
Gross hematuria, hematuria mikroskopik
Proteinuria
Tanda umum peny. Ginjal
Habis olahraga berat, demam
Nefrolitiasis: pengobatan
FIGURE 167
Renal handling of three hypothetical substances X, Y, and Z. X is
filtered and secreted but not reabsorbed. Y is filtered, and a
fraction is then reabsorbed. Z is filtered and completely reabsorbed.
Average Dally Water Gain and
Loss in Adult
Intake Volum Output Volum
In liquid 1200 Insensible 900
loss (skin &
Lung)
In Food 1000 Sweat 50
Metabolically 350 In feces 100
produced
Urine 1500
Total 2550 Total 2550
Daily Sodium Chloride Intake and
Loss
Intake gram Output gram
Food 10.50 Sweat 0.25
Feces 0.25
Urine 10.00
Total 10.50 Total 10.50
PEMERIKSAAN FUNGSI GINJAL
Uric acid
Calcium phosphate
Cystine
Kidney Stones
Calcium oxalate stones
Usually associated with
hypercalciuria
Results from excessive or
impaired calcium
reabsorption, elevated
levels of parathyroid
hormone or vitamin D
Reduction of dietary
intake of oxalate
recommended
Uric acid stones
Develop in highly acidic
urine or in presence of
high amounts of uric acid
or both
Frequently associated
with gout
Diet rich in purines also
contributes
Kidney Stones
Consequences
Renal colic
Hematuria
Urinary tract complications
Prevention & treatment
Increased fluid intake of 12-16 cups daily
- Water, tea, coffee, wine, beer acceptable
- Avoid apple & grapefruit juices(h risk)
Diet & drugs to reduce urinary calcium &
oxalate levels, uric acid levels
Adjustment in calcium (moderate), oxalate (i
levels), moderate protein & sodium intakes,
?purine restriction for uric acid stones
Dietary Treatment of Renal
Stones
Treatment varies based on type of
stone.
Clients should drink lots of fluid.
Eat a well-balanced diet.
Once stones have been analyzed,
specific diet modifications may be
indicated.
Calcium Oxalate Stones