[Type text]

dmd
1.73mm
2
1.73mm
2
Predisposing Fx:
Sex: Female
Age
Postmenopausal Women
Elderly
Precipitating Fx:
Sexually Active
Unhygienic Practices
Use of contraceptives
Comorbid Conditions
Voiding Habits
Neurogenic Bladder

Transurethral Route
Direct Extension
Uropathic
pathogens enter
the bladder
Proliferation of
Pathogens
Bacteriuria (>10
5
of bacteria
per milliliter of urine
Invasion
Functional disruption of
urine flow
Urine stasis
Inc. in bladder
pressure
Urethrovesical reflux Bacteria from the anterior
portion of the urethra are
pulled to the bladder
Destruction of the
mucin layer
Break in the bladder
wall integrity
Inflammation
Damaged and inflamed
mucosa
Cystitis (inflammation of
the bladder)
Bacterial Ascension
Urethritis (inflammation of
the ureters)
Pathogens invade the renal
pelvis and tubules
Inflammatory Process
Acute Pyelonephritis
Repeated bouts or
prolonged inflammation
(Chronic Pyelonephritis)
Post Infection (Beta A
Hemolytic Strep)
Medications
Foreign Serum
Hematogenous Spread
(via bloodstream)
T lymphocytes recognize
these antigens foreign
to the body
B-cells produce
specific antibodies
Formation of Ag-Ab
complexes
Travels thru circulation
Deposition of Ag-Ab
complexes in the
glomerulus
Detection of foreign body
by intracellular receptors
IgG in the glomerular
capillary walls responds
Activation of
immune response
Production of anti-
inflammatory mediators
Increased capillary
permeability
Untreated CKD
Leukocyte infiltration
of the glomerulus
Increased production of epithelial
cells lining the glomerulus
Thickening of the glomerular
filtration membrane
Chronic Kidney Disease
Formation of scar tissues
Loss of Plasma CHON
(albumin)
Hypoalbuminemia Inc. synthesis of
lipoproteins
Dec. oncotic
pressure
Generalized Edema
Hyperlipidemia
Loss of glomerular
filtration membrane
Dec. in glomerular
filtration rate
Prolonged and progressive
kidney damage & continuous
dec. in GFR
Progression to Stage 5
GFR: <15mL/min/1.73mm
2

(Normal: 125mL/min/1.73mm
2)

Kidneys fail to remove the
metabolic wastes and perform
normal functioning
Chronic Renal Failure (End
Stage Renal Disease)
Detrusor
irritation
Detrusor
spasms
Urine Leakage
(urgency)
>Elevated serum
creatinine levels
>Anemia-inadequate
erythropoietin

s/s: Confusion, dry skin,
periorbital edema, crackles,
anorexia, muscle cramps,
Tachypnea, thrombocytopenia
Renal replacement
therapy: dialysis or
kidney transplantation
Urinalysis, multiple-
test dipstick