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1、GeneralintroductionofNephrologyGuYongNephrologydepartmentofHuashanHospitalAffiliatedtoFudanUniversityContentsAnatomyPhysiologicalfunctionCommonetiologicalfactorsSymptomsanddiagnosisTherapeuticsAdvancementRenalanatomyTwokidneyNephron:acinusrenalis&tubulesTubules:Proximal,Henle‘sl
2、oop,distalCollectingductInterstitiumVesselsPhysiologicalfunctionGeneral:MaintaininginternalhomeostasisExcretingmetabolicwastesproductRegulatingwater,electrolyte,acid-basebalanceEndocrine:RAS,PGs,kininsystem,EPOandVitDGlomerularfiltrationTubularreabsorptionTubularexcretionSNGFR=K
3、f(ΔP-Δ∏)=Kf[(PGc-Pt)-(∏Gc-∏t)]Kf:capillarypermeability,filtrationareaDailyglomerularfiltration:180LUrinaryvolume:1000-2000mlProximaltubuleReabsorption(isotonic)Glucose:100%Aminoacid:100%HCO3-:80%H2O:70%NaCl:70%Excretion:OrganicacidDrugsHenle'sloopCountercurrentmultiplicationDist
4、altubuleTodeterminefinalcompositionoftheurineUrearecirculationCommoncausesofrenaldiseasesConnectivetissuediseases,allergyInfection:bacterium,TB,virus,etcRenalvasculardiseaseMetabolism:DM,uricacidHeritage:hereditarynephritispolycystickidneydiseaseDrugpoisoningCirculatoryfailureOt
5、hersSymptomsofrenaldiseasesAcutenephriticsyndromeNephroticsyndromeSymptomlessurineabnormalityAcuterenalfailuresyndromeAcuteurinarytractinfectionsyndromeChronicurinarytractinfectionsyndromeTubularinterstitialdiseasessyndromeChronicrenalfailuresyndromeExaminationanddiagnosisof ren
6、aldiseasesUrineRenalfunctionRenalbiopsyOthersUrineUrinevolumeProteinuriaHaematuriaCastleucocyturiaBacteruriaOthers:color,taste,crystalUrinevolumeNormalurinevolume:1000---2000ml/24haverage：1500ml/24hHypourocriniaoliguria：<400ml/24hanuria：<100ml/24hPolyuria:>2500ml/24hHypourocrini
7、aPrerenal:DecreasedeffectivecirculationvolumeRenal:Glomerular,tubularandinterstitialdiseasesPostrenal:urinaryobstructionpolyuriaDecreasedADHproduction:CentraldiabetesinsipidusRenalinsensitivitytoADH：NephrogenicdiabetesinsipidusImpairedhypertonicityinthemedulla：Primaryurineishype
8、rtonic：osmoticdiuresisPsychogenicpolydipsiaPath
