Kidney Failure & Urinalysis

Kidney Failure

Kidney function is vital to survival and kidneys are so efficient that most people can live with only one. However, poor kidney function can eventually be fatal.

Causes of damage

Kidney disease, heart disease, hypertension (high blood pressure) and diabetes can cause damage to the kidneys requiring treatment.

Glomerular filtration rate (GFR)

Glomerular filtration rate (GFR) indicates how well the kidneys are functioning and estimates the amount of blood passing through the kidneys per minute.
- GFR decreases slightly with age but is markedly decreased if the kidneys are damaged.
  - Normal GFR: 90-100mL/min (90-100% kidney function) up to the age of 70 years.
  - Kidney failure: Less than 15mL/min (<15% kidney function).

Electrolyte balance

Kidney failure affects the balance of electrolytes in the body, most commonly causing:
- Hypervolemia (excess fluid).
- Hyperkalemia (excess potassium).
- Hyperphosphatemia (excess phosphate).
- Hypocalcemia (calcium deficiency).
- Bicarbonate deficiency.

Haemodialysis

Haemodialysis is a type of renal dialysis.
- Sessions happen in a clinic three times weekly and last 3-4 hours.
- A catheter is placed in a large vein in the groin or neck, or a more permanent fistula is created in the wrist or inner elbow.
- 200 mL of blood per minute passes through the dialyser (dialysis machine) and over membranes to exchange substances into the dialysate fluid.

Peritoneal dialysis

Peritoneal dialysis is another type of renal dialysis.
- A catheter is inserted into the abdomen.
- Dialysate fluid is pumped into the peritoneal cavity.
- Waste substances are removed from the blood by exchange into the dialysate across the membrane of the peritoneum.
This can be carried out overnight using an automated machine, or around four times a day with the manual exchange of waste fluid bags.

Kidney transplants

Kidney transplants are sometimes the only appropriate treatment for kidney failure.
- Long waiting lists and the possibility of organ rejection following transplantation means that patients do not always survive long enough for this treatment to work.

Urinalysis

The presence of specific excretory products in urine can be used in diagnostic tests for pregnancy and the use of performance-enhancing and recreational drugs.

Pregnancy testing

Human chorionic gonadotrophin (hCG) is a hormone which is only produced in the urine during pregnancy.
In pregnancy tests, mobile antibodies specific to hCG are attached to enzymes which can change the colour of a dye.
- These antibodies attach to the hCG and move along the test strip with the urine.

Pregnancy testing

More monoclonal antibodies specific to hCG are fixed in a line on the test, along with the substrate for the dye enzyme.
- If the hCG-antibody-enzyme complexes are formed, the enzyme changes the colour of the dye and shows a positive test line.

Anabolic steroids testing

In these tests, the ratio of testosterone to epitestosterone in the urine is measured.
- Increased testosterone levels relative to epitestosterone indicates anabolic steroid use, as normally these are roughly equal.
- This imbalance can remain in the body and be tested for between 14 and 28 days after anabolic steroids have been taken.

Other drugs

The use of many drugs can be detected through urinalysis through the presence of compounds produced when the liver metabolises them.
- Amongst others, these drugs include amphetamines, barbiturates, cannabinoids and cocaine.

1Principles of Science I

1.1Structure & Bonding

1.1.1Atomic Model

1.1.2Electron Shells, Sub-Shells & Orbitals

1.1.3Ionic Bonding

1.1.4Representing Ionic Bonds

1.1.5Covalent Bonding

1.1.6Representing Covalent Bonds

1.1.7Metallic Bonding

1.1.8Intermolecular Forces

1.1.9Intermolecular Forces 2

1.1.10End of Topic Test - Bonding

1.1.11Relative Masses

1.1.12The Mole

1.1.13Molar Calculations

1.1.14Molar Calculations 2

1.1.15Empirical & Molecular Formulae

1.1.16Balanced Equations

1.1.17Percentage Yield

1.1.18End of Topic Test - Amount of Substance

1.2Properties of Substances

1.2.1The Periodic Table

1.2.2Ionisation Energy

1.2.3Factors Affecting Ionisation Energies

1.2.4Trends of Ionisation

1.2.5Trends in the Periodic Table

1.2.6Polarity

1.2.7Metals & Non-Metals

1.2.8Alkali Metals

1.2.9Alkaline Earth Metals

1.2.10Reactivity of Alkaline Earth Metals

1.2.11Redox

1.2.12Transition Metals

1.2.13Redox Reactions of Transition Metals

1.3Cell Structure & Function

1.3.1Introduction to Cells

1.3.2Prokaryotes

1.3.3Organelles of Eukaryotic Cells

1.3.4Organelles of Eukaryotic Cells 2

1.3.5Organelles in Plant Cells

1.3.6Microscopy

1.3.7End of Topic Test - Cell Structure

1.4Cell Specialisation

1.4.1Cell Specialisation

1.4.2Blood Cells

1.4.3Plant Cells

1.4.4Gametes

1.5Tissue Structure & Function

1.5.1Human Gas Exchange

1.5.2Blood Vessels

1.5.3Atherosclerosis

1.5.4Skeletal Muscle

1.5.5Slow & Fast Twitch Fibres

1.5.6Neurones

1.5.7Speed of Transmission

1.5.8Action Potentials

1.5.9End of Topic Test - Neurones & Action Potentials

1.5.10Synapses

1.5.11Types of Synapse

1.5.12Medical Application

1.5.13End of Topic Test - Synapses

1.5.14Chemical Brain Imbalances

1.5.15Effect of Drugs on the Brain

1.6Working with Waves

1.6.1Progressive Waves

1.6.2Wave Speed & Phase Difference

1.6.3Longitudinal & Transverse Waves

1.6.4Stationary Waves

1.6.5Stationary Waves 2

1.6.6Applications of Stationary Waves

1.6.7Interference

1.6.8Diffraction

1.6.9Diffraction Gratings

1.6.10Application of Diffraction Gratings

1.7Waves in Communication

1.7.1Refraction at a Plane Surface

1.7.2Internal Reflection & Fibre Optics

1.7.3Applications of Total Internal Reflection

1.7.4Properties

1.7.5Gamma, X-Ray & UV Light

1.7.6Visible Light

1.7.7Infrared, Microwave & Radio Waves

1.7.8Intensity

1.7.9Digital & Analogue Signals

1.7.10Communication Channels

2Practical Scientific Procedures and Techniques

2.1Titration

2.1.1pH Curves & Titrations

2.1.2pH Curves & Titrations 2

2.1.3Buffer Solutions

2.2Colorimetry

2.2.1Measuring Rates

2.2.2Beer-Lambert Law

2.3Chromatography

2.3.1Overview of Chromatography

2.3.2Thin-Layer Chromatography

2.3.3Column Chromatography

2.3.4Gas Chromatography

3Science Investigation Skills

3.1Scientific Processes

3.1.1Aims, Hypotheses & Sampling

3.1.2Pilot Studies & Design

3.1.3Ethics

3.1.4Variables & Control

3.1.5Demand Characteristics & Investigator Effects

3.1.6Features of Science

3.1.7Scientific Report

3.1.8Scientific Report 2

3.2Data Handling & Analysis

3.2.1Types of Data

3.2.2Descriptive Statistics

3.2.3Presentation & Display of Data

3.3Enzymes in Action

3.3.1Overview of Protein Structure

3.3.2Enzymes

3.3.3Factors Affecting Enzyme Activity

3.3.4Enzyme-Controlled Reactions

3.4Diffusion

3.4.1Diffusion

3.5Plants & Their Environment

3.5.1Factors Affecting Plant Growth

3.5.2Measuring Number & Distribution of Species

3.6Energy Content in Fuels

3.6.1Fractions

3.6.2Burning Hydrocarbons

3.6.3Combustion

3.6.4Energy

3.6.5Energy at Home

3.6.6Calorimetry

3.7Electrical Circuits

3.7.1Circuit Diagrams & Components

3.7.2Diodes, LDRs & Thermistors

3.7.3Resistance

3.7.4Electrical Work

3.7.5Ohm's Law

3.7.6Domestic Uses of Electricity

3.7.7Fuses

4Principles of Science II

4.1Extracting Elements

4.1.1Atom Economy

4.2Relating Properties to use of Substances

4.2.1Group 2 Chemistry

4.2.2End of Topic Test - Group 2

4.2.3Electrolysis

4.2.4Electrolysis Examples

4.2.5Extracting Metals

4.2.6Transition Metals

4.2.7Variable Oxidation States

4.2.8Heterogeneous Catalysts

4.2.9Homogeneous Catalysts

4.3Organic Chemistry

4.3.1Naming Compounds

4.3.2Functional Groups

4.3.3Isomerism

4.3.4Hydrocarbons

4.3.5Structure of Alkanes

4.3.6Boiling Points of Alkanes

4.3.7Alkenes

4.3.8Curly Arrows & Mechanisms

4.3.9Cracking

4.3.10Combustion

4.3.11Free Radical Substitution of Alkanes

4.3.12Electrophilic Addition of Alkenes

4.4Energy Changes in Industry

4.4.1The Kelvin Scale

4.4.2Enthalpy Changes

4.4.3Calorimetry

4.4.4Bond Enthalpies

4.4.5Hess' Law

4.5The Circulatory System

4.5.1The Circulatory System

4.5.2Blood Vessels

4.5.3Blood Transfusion & the ABO Rhesus System

4.5.4The Heart

4.5.5The Cardiac Cycle

4.5.6Cardiac Output

4.5.7Coordination of Heart Action

4.5.8Heart Dissection

4.5.9Controlling Heart Rate

4.5.10Electrocardiograms

4.5.11Cardiovascular Disease

4.5.12Investigating Heart Rates

4.6Ventilation & Gas Exchange

4.6.1Human Gas Exchange

4.6.2Ventilation

4.6.3Measuring Gas Exchange

4.6.4Controlling Ventilation Rate

4.6.5Lung Disease

4.6.6Lung Disease Data

4.7Urinary System

4.7.1Kidneys & Control of Water Balance

4.7.2Kidneys & Osmoregulation

4.7.3Kidneys & Blood Pressure

4.7.4Urine

4.7.5Kidney Failure & Urinalysis

4.7.6Dialysis

4.7.7Transplants

4.8Cell Transport

4.8.1Cell Membrane Structure

4.8.2Diffusion

4.8.3Osmosis

4.8.4Active Transport

4.9Thermal Physics

4.9.1Power & Efficiency

4.9.2Work & Energy

4.9.3Conservation of Energy

4.9.4Pressure

4.9.5First Law of Thermodynamics

4.9.6Second Law of Thermodynamics

4.9.7Heat Engines, Heat Pumps & Refrigerators

4.9.8Non-Flow Processes

4.9.9p-V Diagrams

4.9.10Ideal Gases

4.9.11Ideal Gases 2

4.9.12Thermal Energy Transfer

4.9.13Thermal Energy Transfer Experiments

4.10Materials

4.10.1Density

4.10.2Stress & Strain

4.10.3Properties of Materials

4.10.4Elasticity

4.10.5Plasticity

4.10.6Energy in Materials

4.10.7Young Modulus

4.11Fluids

4.11.1Fluid Flow

4.11.2Viscosity

4.11.3Density

4.11.4Continuity Equation

4.11.5Bernoulli's Equation

4.11.6Non-Newtonian Fluids

5Contemporary Issues in Science

5.1Contemporary Issues in Science

5.1.1Sustainability

5.1.2Genetic Engineering

5.1.3Uses of Genetic Modification

5.1.4Stem Cell Therapy

5.1.5Cloning

5.1.6Cloning 2

5.1.7Nanotechnology

5.1.8Ecosystems

5.2Analysing Scientific Information

5.2.1Validity

5.2.2Peer Review

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