Alteration In Renal Function

More than 20 million North Americans suffer from diseases of the kidneys and urinary tract; about 80,000 die each year because of these diseases. Kidney and urinary tract diseases are a major cause of work loss among men and women: about 10% of America’s outpatient visits result from such problems. The number of persons with chronic and disabling kidney disease has increased, in part because recent advances in dialysis and kidney transplantation methods are keeping persons alive who formerly would have died.

The kidneys are subject to many of the same types of disorders that affect other body structures, including developmental defects, infections, altered immune responses, and neoplasms. The kidneys filter blood from all parts of the body, and although many forms of kidney disease originate in the kidneys, referred to as primary kidney disorders, others develop secondary to disorders such as diabetes mellitus and systemic lupus erythematosus.

The discussion in this article focuses on congenital disorders of the kidneys, obstructive disorders, urinary tract infections, disorders of glomerular function, tubulointerstitial disorders, and neoplasms of the kidneys. 

Congenital Disorders of the Kidneys

About 10% of persons are born with potentially significant malformations of the urinary system. Congenital defects of the kidneys can take several forms: a decrease in the amount of kidney tissue (i.e., agenesis or hypoplasia) or as alterations in the form and position of the kidneys (i.e., kidney displacement or horseshoe kidney). Developmental anomalies of the fetal urinary tract are among the most commonly recognized congenital anomalies. The incidence of lethal anomalies is between 0.3 and 0.7 per 1000 births.