nephric


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Related to nephric: nephric tubule, Nephric duct

renal

 [re´nal]
pertaining to the kidney; called also nephric.
renal clearance tests laboratory tests that determine the ability of the kidney to remove certain substances from the blood. The most commonly used is the creatinine clearance test, which is a measure of the glomerular filtration rate.
renal failure inability of the kidney to maintain normal function, so that waste products and metabolites accumulate in the blood. This affects most of the body's systems because of its important role in maintaining fluid balance, regulating the electrochemical composition of body fluids, providing constant protection against acid-base imbalance, and controlling blood pressure. Called also kidney failure.
Acute renal failure occurs suddenly and may be caused by physical trauma, infection, inflammation, or exposure to nephrotoxic chemicals. Nephrotoxic agents include drugs such as penicillins, sulfonamides, aminoglycosides, and tetracyclines; radiographic iodine contrast materials; and heavy metals. These agents inflict damage on the renal tubules, causing tubular necrosis, and may also indirectly harm the tubules by producing severe vasoconstriction of renal blood vessels with ischemia of kidney tissue. Other causes of tubular ischemia include circulatory collapse, severe dehydration, and hypotension in certain compromised surgical patients.



Acute renal failure may be classified as: prerenal, associated with poor systemic perfusion and decreased renal blood flow; intrarenal, associated with renal ischemia or toxins; or postrenal, resulting from the obstruction of urine flow out of the kidneys.

oliguria is the hallmark of tubular necrosis, but it is not always present. Other symptoms besides a marked decrease in urinary output are related to fluid and electrolyte imbalances, anemia, hypertension, and uremia. In addition to supportive measures to restore and maintain a tolerable internal environment during acute renal failure, it may be necessary to remove toxic wastes by hemodialysis or peritoneal dialysis.
Chronic renal failure is a progressive loss of kidney function that may eventually progress to end-stage renal disease. The clinical course is described in four stages. First there is decreased renal reserve, with diminishing renal function but without accumulation of the end products of protein metabolism; the patient has no symptoms. In the second stage, renal insufficiency, the glomerular filtration rate (GFR) is depressed to about 30 ml per minute and plasma chemistry begins to show abnormalities as waste products accumulate. The third stage, frank renal failure, is characterized by steadily rising serum creatinine and blood urea nitrogen levels accompanying a drop in the GFR. The fourth and final stage is uremia; levels of protein end products continue to rise, residual urine function is less than 15 per cent, and all body systems are impaired.



Causes of renal failure are many and can be roughly divided into three groups: (1) those that directly affect the kidney by infection, inflammation, and upper urinary tract obstruction; (2) those in which there is an obstruction of the lower urinary tract; and (3) systemic diseases and toxicities, such as hypercalcemia, hypertension, disseminated lupus erythematosus, atheroma, and diabetes mellitus.
Treatment. The treatment of chronic renal failure is highly complex owing to its impact on systems throughout the body. It involves prevention of imbalances in water and electrolytes whenever possible and correction of these imbalances when they do occur. Therapy may include phosphate binders to prevent absorption of phosphorus from the intestinal tract, antihypertensive agents to control high blood pressure, diuretics to manage hypervolemia, erythropoietin to manage anemia, and cardiac drugs to manage heart failure. Fluids often are restricted to a given amount during each 24-hour period. Dietary restrictions are aimed at minimizing urea toxicity, controlling various metabolic upheavals and providing optimal nutrition. Protein intake is an especially critical factor because the end products of the metabolism of protein and amino acids are excreted for the most part by the kidney.



Symptomatic relief of the many manifestations of end-stage renal disease is a challenge to every member of the health care team. Virtually every system within the body is adversely affected in some way. Pathophysiologic changes involve the gastrointestinal tract, the skin, the cardiovascular system, the lungs, bone, and blood, and the metabolism of glucose and protein.

Hemodialysis or peritoneal dialysis may be employed to rid the body of wastes that the kidney can no longer handle. For some patients transplantation of a human kidney is a viable alternative to continuous dialysis. Others who cannot withstand surgery and long-term immunosuppression are not good candidates for a kidney transplant.

neph·ric

(nef'rik),
Relating to the kidney.
Synonym(s): renal

nephric

/neph·ric/ (nef´rik) renal.

nephric

(nĕf′rĭk)
adj.
Relating to or connected with a kidney.

nephric

adjective Referring to the kidneys.

NEPHRIC

Abbreviation for:
Nephrotoxicity in High-risk Patients Study of Iso-osmolar and Low-osmolar Non-ionic Contrast Media

neph·ric

(nef'rik)
Relating to the kidney.
Synonym(s): renal.

neph·ric

(nef'rik)
Relating to the kidney.
Synonym(s): renal.

nephric

pertaining to the kidney.
References in periodicals archive ?
The NEPHRIC results show that the use of Visipaque(TM) significantly reduced this risk, with patients given Visipaque(TM) being 11 times less likely to develop kidney damage than those administered a conventional non-ionic contrast medium.
PAX2 is one of 9 paired-box transcription factors, a master organizer gene expressed in the nephric duct, metanephric mesenchyme, ureteric bud, and S-shaped body.
It should be clear that while the NEPHRIC study showed some clinical advantage of Visipaque over Omnipaque in diabetic patients undergoing angiography, the findings do not support that Visipaque offers a better renal safety profile than Isovue or other nonionic contrast media, in angiography or any other contrast-enhanced radiographic procedure.