The human body relies on homeostasis to function properly, so the body makes adjustments constantly to keep balanced within physiological limits. The kidneys in the urinary system are a major workhorse in keeping the body in balance. They regulate the ionic composition of blood, pH of blood, blood volume, blood pressure, blood glucose, production of hormones, and excretion of foreign materials and waste products (Jenkins & Tortora, 2013). If this process fails or there is impairment (renal failure), then a person relies on dialysis to artificially clean the blood, remove excess fluid and electrolytes. The patient will have to go to a facility to have this done on a routine schedule. The dialysis machine uses dialysate solution to maintain diffusion gradients that help with removing waste and add other substances; meanwhile the patient will also be heparinized to prevent clotting during the procedure. Patients with renal disease or renal failure have a lot of electrolyte imbalances and most commonly will present hyperkalemia (too much calcium). The excess calcium can cause arrhythmias.
After dialysis the patient usually will have severe cramping due to the shift in pH and removal of excess fluids (concentration). Patients are at risk for thrombosis, urine retention or incontinence, insomnia, imbalanced glucose, dehydration and hypertension. Homeostasis is key for all systems of the body to function, including temperature regulation. The enzymes have a specific range in which they can work. The patient can help their situation by strictly following a prescribed diet; including proper hydration and getting enough exercise and sleep (Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. Connection Between Salt and Water in Maintaining Blood Volume and Blood Pressure Changes
Water and salt play an important part in blood volume and blood pressure. The first step in regulation of blood volume is in the kidneys; where water and salt are excreted into the urine, based on the needs of the body. One factor controlling water and salt is based on hormone response. The renin-angiotensin-aldosterone (RAAS) hormones effect the release on water and salt into the urine. Sodium is controlled by angiotensin II along the proximal tubule, loop of Henle and the distal tubules. Aldosterone in the collecting tubules also stimulates sodium to move from the tubules into the interstitium, bringing water along as well and increasing blood volume, thus increasing blood pressure.
The antidiuretic hormone (ADH) is on the end of the distal tubules and allows for more water resorption. Water will reenter the interstitium if the existing is hypertonic by way of osmosis to reduce water loss and urine volume. High blood volume increases blood pressure, which increases the blood flowing through the kidneys (Cardiovascular Physiology Concepts, n.d.). This increases the glomerular filtration rate which will put more water and salt into the urine and then lower the blood volume and reduce the blood pressure because of a higher/faster rate of processing. Homeostasis is always trying to be achieved.
Cardiovascular Physiology Concepts. (n.d.). CVPhysiology. Retrieved May 6, 2014, from http://www.cvphysiology.com/Blood%20Pressure/BP025.htm Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. (n.d.). Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Kidney Disease. Retrieved May 6, 2014, from https://www.kidney.org/professionals/kdoqi/guidelines_bone/guide6.htm Jenkins, G. W., & Tortora, G. J. (2013). Anatomy and physiology: from science to life (3rd ed.). Hoboken, NJ: Wiley.
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