医院内科泌尿系统疾病教学课件.ppt

The most common host factor predisposing to UTI: Urinary Stasis Vesicoureteric Reflux, VUR Obstructive uropathy （尿路梗阻） Neuropathic bladder （神经原性膀胱） Immunity Nephrotic Syndrome Urinary Tract Infection Clinical features In neonates and very young infantile jaundice may occur and septicemia may develop In infants, UTI may occur with or without fever and symptoms are non-specific: vomiting, diarrhea, irritability, failure to thrive Between 1 and 5 years of age, fever, malaise, abdominal discomfort, urinary frequency, and nocturnal enuresis are the presenting features UTI must be suspected in any febrile infant with no obvious clinical source Very Important!  UTIrecurrent UTI VUR  Renal Scar (肾瘢痕) Hypertension/Reflux Neohropathy  ESRD  Very Important! * CAKUT account for up to 40% of the causes of ESRD in children in our population. * CAKUT account for up to 40% of the causes of ESRD in children in our population. 泌尿系统疾病Diseases?of?Urinary?System / Urinary Tract Disorders Kidney 肾脏 Ureter 输尿管 Bladder 膀胱 Urethra 尿道 Contents Laboratory and image Evaluation of Urinary System Urinary Tract Infection (Vesicoureteric Reflux 膀胱输尿管反流) Acute Nephritis Nephrotic Syndrome Evaluation of Urinary System Laboratory Evaluation of Renal Function Urinalysis Serum Analysis (BUN, Cr, Albumin, pH, K+ Na+ Cl-) Urine Culture Three urine samples are shown. The one at the left shows a red, cloudy appearance. The one in the center is red but clear. The one on the right is yellow, but cloudy. white blood cell cast red blood cell cast oxalate crystals Evaluation of Urinary System Laboratory Evaluation of Renal Function Measurement of Glomerular Filtration Rate, GFR (Ccr, eGFR) Urine Concentrating Ability 尿浓缩功能 1,25(OH)2 Vitman D EPO （促红细胞生成素） La