gangguan faal ginjal
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GANGGUAN FAAL
GINJAL
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Renal Physiology, Electrolytes and
Renal Failure
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FUNGSI GINJALMemertahan!an "#ME#S$ASIS
1. Mempertahankan keseimbangan H2O
2. Mengatur jumlah dan konsentrasi sebagian besarion CES
3. Memelihara volume plasma
4. eseimbangan asam!basa
". Memelihara osmolaritas
#. Eliminasi sisa metabolisme tubuh
$. Sekresi sen%a&a asing
'. Membentuk hormon eritropoetin
(. Sekresi renin
1).Mengubah vit * menjadi bentuk akti+
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%hat you need to !no&'
Renal anatomy(ontrol o) *asculartone
$u+ular )unction"andling Na-&ater"andling ., (I"andling acid
Pathohysiology o)renal )ailure
Electrolyte disordersAcid/0ase disorders%ater disorders
(onduit-ouch e1ects#+struction e1ectsStones-R$A2iuretic e1ectsSurgical issues in renal)ailure atient
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NEFR#N 3 satuan )ungsionalgin4al
1 juta ne+ron , ginjal
-e+ron adl satuan terkeil %ang mampumembtk urin
Susunann%a didlm ginjal/ kortek dan medula 0iap ne+ron / komponen vaskular tubulus
komponen vaskular/ rteriol a kapilerglomerolus arteriol e kapilerperitubulus venula
omponen tubulus/ kapsula 5o&man tubproksimal lengkung Henle tub distal
tub pengumpul
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5 Proses em+entu!an urin
67 Filtrasi glomerolus
87 Rea+sor+si tu+ulus
57 Se!resi tu+ulus
1') liter 64$ galon7 8ltrat glomerolus ,hari
1$'." lt diserap kembali
1." lt dikeluarkan sebagai urin
Setiap %ang di8ltrasi atau disekresi tetapitidak direabsorbsi akan dieksresikandalam urin
6bedakan istilah eksresidan sekresi7
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Physiology
Liquids flow from high pressure low pressure
Heart the driving force for urine flow
Disruption of urine flow occurs if collecting
system pressure rises above 30 cmH2
!he collecting system runs from the renal
pelvis to the bladder and is a dynamic structure
designed to store and then to conduct urine tothe outside while maintaining a low and safe
pressure"
9aediatri:rolog%
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Renal "emodynamic 2e9nitions
Renal 0lood Flo& :R0F;
! blood to kidne%s per minute 612)) ml,min7
Renal Plasma Flo& :RPF;
! plasma ;o& to kidne%s per minute 6#$) ml,min7 Glomerular Filtration Rate :GFR;
! volume o+ plasma 8ltered per minute b% theglomeruli 612" ml,min males< 1)) ml,min
+emales7
Filtration Fraction :FF;
! =>?/?9> 6about .1'!.227
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GFR
balane o+ h%drostati and onotipressures
h%drostati pressure ontrolled b% relative
toniit% o+ pre! and post!glomerulararterioles
h%per!renin state &ill maintain =>? b% post!glomerular arteriolar onstrition
=>? ma% be appro@imated b% reatininlearane< sine Cr 8ltered< not reabsorbedand minimall% sereted
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(ontrol o) Renal Artery$one
Aasoonstritors# Endothelin
# angiotensin BB
! atrial natriureti peptide
Aasodilators
! 9=E!2
! aet%lholine
serotonin,brad%kinin 6-O mediated7
gluoortioids
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$u+ular Function
maintain appropriate &ater< aid and
eletrol%te balane using passive andative mehanisms
reabsorb seletivel% up to ((D o+ theglomerular 8ltrate
respond to endorine signals to makeneessar% hanges
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0ubular Organiation
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Pro
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Loo o) "enle
earl% &ater and urea permeabilit%
derease urinar% alium
in *B< the% have an anti!diuretieet
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Loo 2iuretics
+urosemide< etharini aid
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