The urinary tract is also called the urinary system, consisting of the kidney, ureters, bladder and urethra (Amerman, 2016). The urinary system main function is to preserve homeostasis through water and electrolytes conservation and also excrete toxins from the body (Amerman, 2016). The kidneys filter blood and balance fluids in the body; the ureters are channels through which urine travels to the bladder. Urine is stored in the bladder before it is passed out of the body through the urethra (Amerman, 2016). The urinary system can be attacked by infections causing blockage, damage, and injuries to the tissues impeding its normal functions (Amerman, 2016). This paper reviews two articles that provide insight into the pathology and imaging of the urinary system.
The amount of filtrate formed by both kidneys in 1 minute is known as the glomerular filtration rate (GFR), and the normal rate is about 125ml/min (Amerman, 2016). When the GF rate decreases, one may have a renal failure where the kidneys cannot perform its function. Renal failure can be caused by many conditions which include obstruction of the urine outflow, decreased blood flow to the kidneys and kidney diseases and infections (Amerman, 2016). An acute renal failure can be treated and resolve completely whereas other patients develop long-term renal failure leading to the end stage kidney disease (Amerman, 2016). Patients with chronic renal failure risk developing hypertension and diabetes mellitus (Amerman, 2016).
Some of the symptoms of a renal failure are edema, loss of appetite, and fatigue (Amerman, 2016). In cases where the GFR drops below fifty percent, patients develop a condition called uremia that is characterized by the electrolytes and acid-base imbalances, fluids and wastes retention (Amerman, 2016). Uremia can cause seizures, coma and eventually death if untreated. Dialysis treatment is initiated for patients with the uremia condition (Amerman, 2016). Two types of dialysis treatment exist; hemodialysis which removes a patient’s blood and filters it through a filter (Amerman, 2016). Hamodialysis is normally done three times a week (Amerman, 2016). The other type of dialysis is the peritoneal dialysis, the dialysis fluid is placed into the peritoneal cavity and allowed to circulate then it is drained after several hours. The procedure can be done every night making it ideal for patients that require long-term dialysis (Amerman, 2016).
Different tests techniques can be used for diagnosis of the urinary system. They include blood and urine tests, imaging and kidney biopsy (Lam & Hall, 2013). A blood test involves testing for BUN (blood urea and nitrogen) and creatine, which are wastes excreted by the kidneys (Lam & Hall, 2013). When the kidney is not functioning well, the wastes are present in blood in high levels. Urine test measures the ability of the kidneys to filter blood. The glomerular filters waste while and protein and red blood cells remain in the bloodstream. When the glomerular are damaged, proteins and red blood cells leak into the urine (Lam & Hall, 2013).
Imaging tests are more effective as they present minimal risks and discomfort to the patient. They include intravenous pyelogram (IVP), Ultrasound, computed axial tomography (CAT) scan, magnetic resonance imaging (MRI) (Lam & Hall, 2013). The ultrasound test uses sound waves to provide images. The procedure is used to determine the size of the kidneys and detecting cysts. Also, it can detect scars on the kidney and any blockage in the urinary system. The IVP applies X-rays to produce pictures of the urinary system (Lam & Hall, 2013). A contrast dye is used to produce two-dimensional black and white images. IVP produces detailed images of the kidney and can show any kidney stones, tumors, and cyst (Lam & Hall, 2013). IVPs cannot be done where the kidneys functions are reduced as they cannot process the contrast dye to produce images and can complicate the state of the kidney (Lam & Hall, 2013).The CAT scan produces images in crosswise slices. It can detect a blockage, kidney stones, solid masses and cyst. A CAT scan can see all the parts of the abdomen making it more effective. It cannot be used on patients with reduced kidney function as it uses contrast dye (Lam & Hall, 2013). An MRI scan creates images based on different organs and tissues molecular composition when exposed to strong magnetic fields (Lam & Hall, 2013). The images of an MRI scan are fine compared to the CAT scan and ultrasound (Lam & Hall, 2013).Patients with metal devices in their bodies cannot be subjected to the MRI scan. The scan requires patients to lie still in the dark without getting distracted by the machinery, making it difficult for a patient. The technique uses a dye called gadolinium which can cause a condition known as nephrogenic system fibrosis to a patient with reduced renal function (Lam & Hall, 2013).
Kidney biopsy which is also called renal biopsy is a process that involves an examination of a tissue sample from the urinary system ((Lam & Hall, 2013). It uses an ultrasound and CAT scan to determine the location of the kidney. The biopsy is normally done on either one of the kidneys unlike the rest of the techniques, in a biopsy, there has to be an incision to access the tissues (Lam & Hall, 2013). The specimens are studies using different microscopic methods for one to two weeks for a diagnosis (Lam & Hall, 2013).
References
Amerman, E. (2016). The Urinary System. www.pearsonhighered.com. Retrieved 13 April 2016, from https://www.pearsonhighered.com/amerman-1e-info/assets/pdf/amerman-sample-chapter24.pdf
Lam, M., & Hall, P. (2013). Tests Used to Diagnose Kidney Disease. Netwellness.org. Retrieved 13 April 2016, from http://www.netwellness.org/healthtopics/kidney/kidneytests.cfm
