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Table of Contents
Renal Failure: current challenges from dialysis to transplantation
Topic 9 - Team R
- Marcel Eisenmann (212015)
- Ghazal Honarpisheh (231966)
The urinary system includes kidneys and related structures that form the body's excretory system. The kidneys (lat. Ren; gr. Nephrons) are playing an important role by the detoxification of the human body through filtering blood and creating urine. They also have a role in controlling the body’s PH, hormone secretion, regulation of osmolality and arterial blood pressure.
The condition in which kidneys do not work properly is called Renal Failure. This disease can be caused by different factors such as not getting enough blood or being blocked by a kidney stone. There also some diseases which can lead to renal failure such as diabetes and high blood pressure.
When kidneys fail (renal function below 15%), dialysis is a method by the help of which patients can keep their bodies in balance. There are two main types of dialysis; hemodialysis and peritoneal dialysis. Although dialysis does help patients by working like a healthy kidney, it is not a cure, and patients should do dialysis treatments for their whole life unless they do kidney transplantation.
The Transplantation of a healthy kidney can be seen as the last step to treat renal failure. There are two kinds of kidney donors: deceased donors and living donors. Depending on the donor type, kidneys can prolong the life expectations of the patient for 10 to 15 years compared to the dialysis treatment. But transplantations entail a high risk of rejecting the transplanted organ. Other contraindications could be cardiac and pulmonary insufficiency or infections. Nevertheless, a transplantation brings back a higher quality of life with less restricted diets and complications compared to the conventional dialysis.
Every minute two organs looking like beans are filtering 0.2 liter of blood. The kidneys are fulfilling a full-time job without any perception by the human beings. Nevertheless the renal system, including, kidneys, ureter, bladder and urethra are of immense importance. A renal failure would causing the death if not treated early enough.
Anatomy of the urinary system
The urinary system includes the kidneys and its related structures which form a part of the human body's excretory system. This system's components, which is also known as the renal system, are as follow:
- Urinary bladder
The urinary system produces, stores, and eliminates urine. Urine is the fluid waste made by kidneys through the process of filtering the blood in order to eliminate wastes and extra water from it. Urine flow from the kidneys and passing ureters (two thin tubes), it fills the bladder. As the bladder gets full, a person can urinate and eliminate the fluid waste through the urethra.
Anatomy and histology of the kidney
What are the kidneys?
The human body contains two kidneys located at the posterior wall of the abdomen, outside the peritoneal cavity; one on the left side and the other the right. As can be seen in the figure bellow, due to the presence of the liver, the right kidney lies a little lower than the left one.
Anatomy and histology of ureter & bladder
The ureter is a 25-30 cm long tube of smooth musculature. By means of rhythmic movement (peristalsis) it guides the urine from the kidney into the bladder. Its connective tissue sheath (tunica adventitia) anchors it displaceably in the retroperitoneal tissue. There are three different sections:
- Pars abdominals
- Pars pelvica
- Pars intramuralis
The bladder (Vesica urinaria) is a muscular hollow organ which collects and stores (continence) the the urine from the kidney. It is located at the base of the pelvic floor. The urine enters the bladder via the ureter and exits through the urethra. The size of the bladder can change through relaxing and extending of the bladder's wall dependent on the volume of liquid inside. A typically human bladder will contain 300 to 500 ml until the urine needs to be released. But it is able to hold even more.
As it can be seen in the figure the wall of the bladder is micro-anatomical organised into the following layers from inside to outside:
- Lining epithelium
- Lamina propria
- Muscularis propria
Physiology of metabolism of substances
Excretion of metabolic or toxic substances via the urine
Introduction into the female pelvis and pelvic organs
Current challenges with renal failure
Transplantation & Dialysis
 J. E. Hall, Guyton and Hall Textbook of Medical Physiology. Elsevier LTD, Oxford, 2020-06-19.
 https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-urinary-system  https://viamedici.thieme.de/lernmodule/anatomie/harnleiter+ureter?langtext=false#_245413C0_0FDE_4FB2_A36E_98C1CD8940B4