,,-, - , ,

- - - - - -

,

2006

1- 1200 . . 1700 2- 3- 1020 4- 15

5- 8

6- ( ChronicKidneyDiseases)

7-40 1% ,

8- 0.5% 20-25% 9-

10- 50 ( 10%)

11-

12-. ,1954

( ) ( renal fascia) 115170 11-14,6 3

,

(renalhilum) ,

(renalcapsule)

( parenchyma) ( renalcortex) ( renalmedulla)

,

,

,

(Nephrons)

,

( renal corpuscle) ( renaltubule) , , ,

( papilla) ( minor calyx) , ( major calyces) (renalpelvis)

- , , (extracellular fluidvolume)

, ,

II, ,

,

,

, 180

,

2

,

-

-

- , (pH) - (HCO3) -

( plasma osmolality)

(antidiuretic hormone) (ADH) ,

( Principal Cells) (aquaporins) , ( vasarecta) ,

()

(singleeffect)

( ADH) ( aquaporins)

(ADH) .

, - countercurrentsystem ,

- ,

, ,

, -

II

,

,

, II

,

, ,

( ) - ( ) ,

-=

,

, ,

ADH, 8-15 , 10-20

1--85% 2-

Capillaries

Afferentarteriole

Efferentarteriole Arteriole

,

U

Ultrafiltration

-

(Non-selective&Passive) , ( ...)

20

(, , , , , ,

) , ( )

Glomerular Filtration Rate GFR

. . .125 115

. . .

(Systole&Diastole) -

( )80mm 180mm . . . 80mm . . . 180 mm . . . . . . 1- 2- 3- - - . . . - -

. . .

. . .

PCT

,

,

- S1 S2 S3

Na+/K+ ATPase 65 %

50 %

300mOsM

300mOsM

100 % , ,

,

- 50%

,

. . .

300 mOsM-1200mOsM

1- 2- 3- 4- 5-

-1200mOsM

( Epithelium) Na-K-2Cl ( ) - /

,

,

1200 mOsM- 100mOsM ,

Efferentarteriole

() (Gradient) interstitium

25 %, 25 % 40%

DCT

PCT

... ,

() ... ( )

15-20% , ,

( - ) - ( ) ... / , / ... - ... / / /

... ( )

WNK ( )

-

- ,

- 5% 24%

(ADH)

-2

, ,

( - )

- ... /

1200 mOsm/L( ) 1200ml/day GFR0.66%

,

. . .

,

( )

1- - ,,

() . . .

,

. . .

2- - -1 -

- . . .

3-

,

,

515 - -

- , -2 ,

2030 ,

40% ( )

,

2430. . 24 300. .

20-40

-2

( ) GlomerularFiltrationRate

( )GFR ( Microalbuminuria ) 30. .24

-

300

. .24 ,

GFR 10 ml ,

, ( ) ( ) - ,

-

............

,

,

-

-

94 45

, 18

130 80

Angiotensin-ConvertingEnzyme Inhibitors ... ( , , , ) ... - , Angiotensin Receptor Blocker (ARBs) ,

- ( )

0.8 .

( , , - Electrolytes, ) GlomerularFiltrationRate(GFR)-10 . .

Semipermeablemembrane

Diasylatefluid

Diffusion &Osmosis

10 . . - KidneyFailure - breathlessness, ,

,

,300 500

,

- -

30

( )

-

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-

. . ,

. .

,

( , )

,

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,

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,

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,

,

12

3 4

250-300..

,

,

, ( )

( )

34

,

, .. ( Reverse Osmosis Plant )

?

,

,

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,. ., ,

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/ -

( )

-

,

50,000

,

,

-

,

1.5%,2.5% 4.25%

,

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,

- ,

5-6..

-

,

(PET)

...

,

24

,

,

,

KT/V

,

,

,

( ) ,

IPD

36

30

40

,

. . ..

, , ,,

,

,

, ( - ), ,

10-12

10-15

5-10

,

? 1855

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,,,

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?

, , ,

, -

? ,

?

-, ,

CMV EBV

,DTPAGFR

, ..

...

100 %

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(Rt. IliacArtery&Vein)

24

,

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,

,

,

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...2011 ( )

( )

( ) - ( ) 225-250

, ,

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