Ingrijirea Bolnavului Cu Colica Renala

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    MINISTERUL EDUCAIEI NATIONALECOALA POSTLICEAL SANITAR

    CAROL DAVILA

    PROIECT DE ABSOLVIREDOMENIU: SANATATE SI ASISTENTA PEDAGOGICACALIFICARE PROFESIONALA: ASISTENT MEDICALGENERALIST

    COORDONATOR:

    PROF. TULACHE GINA ABSOLVENT:ALEXANDRU ANDREEA-SORINA

    CLASA-III-G

    BUCURESTI20!1

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    INGRI"IREA BOLNAVULUI CUCOLICA RENALA

    2

    www.referat.ro

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    ContentsCAPITOLUL 1 ANATOMIA I FIZIOLOGIA PARATULUI EXCRETOR I EXCREIA.......4

    1.1.Rinichi!................................................................................................................................41.1.1.Situare.............................................................................................................................41.1.2.Forma.............................................................................................................................41.1.3.Aspect exterior...............................................................................................................41.1.4.Structura rinichiului.......................................................................................................41.1.5.Orientare........................................................................................................................."1.1.6.Numr. Greutate. Dimensiune......................................................................................#1.1..!uloare. !onsistent .....................................................................................................#1.1.".Delimitare.......................................................................................................................#1.1..#.. $o%a renala.......................................................................................................................#1.1.1&.!ile excretoare ale rinichiului....................................................................................$

    1.2. %&sc!&'i(&)i& *i ine'+&)i&.....................................................................................................$1.2.1.'asculari(atia )enoasa...................................................................................................$1.2.2.!alicele mici...................................................................................................................$

    1.2.3.!alicele mari..................................................................................................................$1.2.4 . *reterul.......................................................................................................................1,1.2.5.'e(ica urinara...............................................................................................................111.2.6. *retra..........................................................................................................................12

    1.-.Fi(io!oi& &/&'&t!i e0c'eto'..............................................................................................141.3.1. Generalit+i..................................................................................................................141.3.2. Formarea urinii...........................................................................................................1"1.3.3. Filtrarea ,lomerulara..................................................................................................1"1.3.4. -easor+ia tuular...................................................................................................11.3.5. Secre+ia tuular.........................................................................................................11.3.6. -e,larea ner)oas.......................................................................................................1#

    1.3.. -e,larea umoral........................................................................................................1#1.3.".!aracteristicile /i compo(i+ia urinii.............................................................................1#1.3.#. 0ictiunea.....................................................................................................................2,

    CAPITOLUL 2 NOIUNI 3EPRE5COLIC6 RENAL6...........................................................222.1.3e7ini)ie...............................................................................................................................222.2 C&(e...................................................................................................................................222.-. F&cto'i 8e 'isc.....................................................................................................................2-2.4. C!&si7ic&'e& c&!c!i!o' 'en&!i...............................................................................................2-2.". Co9/o(i)i& c&!c!i!o' 'en&!i...............................................................................................242.. i9/to9&to!oie.................................................................................................................242.. 3i&nostic...........................................................................................................................2"

    2.#T'&t&9ent..............................................................................................................................2"2.".1ratament naturist.........................................................................................................2"

    2.$.E+o!)ie *i co9/!ic&)ii.........................................................................................................2CAPITOLUL - :NGRI;IREA.PACIENTULUI CU COLIC6 RENAL6....................................2#PLANUL 3E INGRI;IRE.............................................................................................................-1

    t8i! 8e c&( 1.........................................................................................................................-1t8i! 8e c&( 2.........................................................................................................................-4t8i! 8e c&( -.........................................................................................................................-

    Conc!(ii........................................................................................................................................4,

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    CAPITOLUL ANATOMIA I FI#IOLOGIA PARATULUIEXCRETOR I EXCREIA

    G$%$&'()*+,)Ene'i& /e se&9& c>'ei& co'/! o9!i t'>ie*te *i 9nce*te 'e(!t> 8in 8esco9/ne'e&s=st&n)e!o' nt'iti+e &8se 8e s?ne !& ce!!e.3in &ceste 8esco9/ne'[email protected] /e !?n& e!i=e'&'e& 8eene'[email protected] 'e(!t> *i &/>@ CO2 *i &!)i /'o8*i c&'e /'in &c9!&'e 8e+in to0ici /ent' o'&nis9.

    U'ee& *i &ci8! 'ic 'e(!t> 8in 8esco9/ne'e *i t'e=ie e!i9in&te /e 9&i 9!te c>iBCO2 *i o /&'te 8in &/> se e!i9in> /e c&!e /!9on&'>@ /'in e0/i'&)[email protected] s& /'in /ie!es=

    7o'9& 8e s8o&'eDBo'&ne!e !& ni+e!! c>'o'& se 7o'9e&(& 'in&RINICIIi9/'en> c o'&ne!e 9&'i c&'e

    con8c 'in& !& e0te'io'C6ILE [email protected] &!c>tiesc APARATUL EXCRETOR.

    ..R)%))/(

    1.1.1.SituareRinichii snt o'&ne 'et'o/e'itone&[email protected] sit&te 8e o/&'te * i 8e &!t& & co!o&nei !o9=&'[email protected] n

    7ose!e !o9=o58i&7'&9&tice. Fiec&'e 7os> !o9=o58i&7'&9&tic> &'e 2 /o')ini n& !o9=&'> *in& 8i&7'&9&tic>@ se/&'&te 8e inse)i& !o9=&'> & 8i&7'&9!i. Po')ine& 8i&7'&9&tic>co'es/n8e 8i&7'&[email protected] i&' /o')ine& !o9=&'> este 8e!i9it&t> n ss /e co&st& & 125&@ n Hos8e c'e&st& i!i&c&@ 9e8i&! 8e co!o&n& +e'te='&!> s/'&7&)& /&')ii !o9=&'e este 7o'9&t> 8e9*chii t'&ns+e'*i &i &[email protected] />t'&t &! !o9=e!o' *i i!io/so&s.

    liopsoas 9sc=i &!c&tit 8in 9schii i!i&c si /so&[email protected] c&'e & n ten8on co9n.1.1.2.Forma

    Fo'9& 'inichi!i [email protected] 8e [email protected] co9/&'&t> c & ni =o= 8e 7&so!e. L& non&sc)[email protected]'inichii snt 'otnHi)[email protected] o+oi8&!i.1.1.3.Aspect exterior

    Fiec>'i 'inichi i se 8istin o 7&)> &nte'io&'& *o' con+e0>@ o 7&)> /oste'io&'& /!&t>@ oe0t'e9it&te s/e'io&'> 'otnHit>@ o 9&'ine !&te'&!& con+e0> *i o9&'ine 9e8i&!> conc&+>@ /e c&'e se >se*te hi!! 'en&!.

    i!! 'en&! este o 8es/ic>t'& 9&'init> 8e o=(>&nte'io&'> 9&i 9ic> * i n& /oste'io&'> 9&i 9&'e e! estest'&=>tt 8e e!e9ente!e /e8ic!!i 'en&! *i con8ce nt'5oe0c&+&)ie sit&t> n /'o7n(i9e& '[email protected] n9it> sins 'en&!.1.1.4.Structura rinichiului.

    Rinichi! este &co/e'it !& s/'&7&t> 8e oc&/s!> 7i='o&s> c&'e &'e n st'ct'& s& 7i='eco!&ene *i 7i='e e!&stice. = c&/s!> se &7!> n st'&t s=)i'e *i 8icontin 8e 7i='e 9sc!&'e*i nete8e. :n &7&'& c&/s!ei se &7!> o /eni)> &8i/o&s& '&so&s&D. Pe o sec)ine 7'ont&!> se+e8e c> 'inichi! este &!c>tit 8int'5n st'&t /e'i7e'ic 8e c!o&'e ='n &!=ie Js=st&n)&co'tic&!>J *i o(on> inten> 8e c!o&'e 'o*ie inchis Js=st&n)& 9e8!&'>J.

    Zon& 9e8!&'> este 9&i ntins> *i con)ine 14 /i'&9i8e 'en&!e n9ite /i'&9i8eM&!/ihi +?'7! /i'&9i8e!o' se n9e*te /&/i!> 'en&!> *i este in8'e/t&t s/'e sins! 'en&!.Pi'&9i8e!e & &s/ect st'i&t 8&t 8e /'e(en)& t=i!o' co!ecto'i se n9esc t=i

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    &!c>tie*te n !o= 'en&! 7iec&'e !o= 'en&! &+?n8 /'&ctic -,, 8e !o='i 'en&!i n9>'!

    !o=!i!o' 'en&!i este e&! c ce! &! /i'&9i8e!o' 'en&!e M&!/ihi. L& ni+e!! 'inichi!i se >sescne7'oni sit&)i &t?t n co'tic&!> c?t *i n 9e8!&'>. Ei 'e/'e(int> nit&te& st'ct'&!> *i 7nc)ion&!>& 'inichi!i. E0ist> &/'o0i9&ti+ 2 9i!io&ne 8e ne7'[email protected] 8&' c& ne'oni n 7nctione&(> to)i in&ce!&*i ti9/. Ne7'on! este 7o'9&t 8int'5n co'/sc! 'en&[email protected] t=! conto't /'o0i9&[email protected] &ns& [email protected]=! conto't 8ist&[email protected] c&'e se 8eschi8 n t= co!ecto'.

    Co'/sc! 'en&[email protected] M&!/ihiD este sit&t n co'tic&!> *i &'e n st'ct'& s& n !o9e'!+&sc!&' o c&/s!> *in& /&'iet&!> nt'e c&'e se5&7!> n s/&)i 8e co!ect&'e& 'inei. Ce!e 8o> 7oi)e +isce'&!> *i

    /&'iet&!> snt 7o'9&te 8int'5n st'&t [email protected] ce!!e t'[email protected] &*e(&te /e st'ct'& cnosct> & /e'ete!ic&/i!&' s&nin [email protected] 9e9='&n> =&(&!>@ /e'ite!iD. [email protected] !o9e'!! 'en&! /'e(int&

    n /o! +&sc!&' 5 c&'e /'e(int> !oc! 8e /&t'n8e'e *i ie*i'e &! +&se!o' n co'/! 'en&!n /o! 'in&' 5 !& ni+e!! c>'i& se /et'ece 'in& 8int'e et&/e!e 7o'9>'ii 'inei.:n contin&'e se &7!> t=! conto't /'o0i9&! 5 c&'e /'e(int> o /o')ine n (on& co'tic&!> * i

    n& n (on& 9e8!&'> &ns& !i en!e5n t= n 7o'9> 8e U c&'e /'e(int> o '&9'>8escen8ent> *in& &scen8ent> t=! conto't 8ist&! 5 se contin> c t=! co!ecto' c&'e se

    +&'s> n t=i 'ini7e'[email protected] &9=ii 8?n8 &s/ect! st'i&t &! /i'&9i8ei M&!/ihi.1.1.5.Orientare

    Rinichii snt sit&)i c &0! 9&'e o=!ic 8e ss n Hos *i 8in&nt' n &7&'> &st7e! /o!iis/e'io'i snt 9&i &/'o/i&)[email protected] 5c9D *i c /o!ii in7e'io'i 9&i 8e/>'t&)i 1,512 c9D. A0e!et'&ns+e's&!e snt * i e!e o=!ice 8in>nt' n &7&'> *i 8in&inte in&/oi. Ast7e! nc?t 7&)&&nte'io&'> /'i+e*te n&inte *i n &7&'&@ i&' ce& /oste'io&'> /'i+e*te n&/oi *i n&nt'.

    "

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    Fiec&'e ne7'on se co9/ne 8in!o9e'!! !i M&!/ihit=! conto't /'o0i9&!&ns& !i en!e c '&9'i!e s&!e&scen8ente *i 8escen8entet= conto't 8ist&!c&n&!e!e 8e ni'e

    t=i co!ecto'iG!o9e'!! 5 /'i9! e!e9ent &! ne7'on!i este &!c>tit 8int'5n he9 8e c&/i!&'e c&'e

    'e(!t> 8in '&9i7ic&)ii!e nei &'te'io!e &7e'[email protected] /'o+enit> 8in &'te'& 'en&!>. C&/i!&'e!e se 'enesc&/oi *i 7o'9e&(>@ o &'te'io!> e7e'ent>@ c&'e se c&/i!&'i(e&(> 8in no n H'! /'i9ei /o')ini &t=!i 'ini7e'.

    t'ct'i!e ce'e se int?!nesc in !o9e'! snt9e9='&n& =&(&!? & c&/s!e !i

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    T= 'ini7e' &! 8oi!e& e!e9ent &! ne7'on!i se /'e(int>@ s= 7o'9& ni c&n&! !n 8e ",[email protected] 7o'9&t 8in '9>to&'e!e se9ente c&/s!& n9e!e 8e co'/sc!

    M&!/ihi.

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    1.1.6.Numr. Greutate. Dimensiune.

    N9>'! 'iniehi!o' este [email protected] '&'eo'i 1 s& - in &n9ite 9&!7o'9&)iiD.Rinichi! &8!t!i c&nt&'este 12,51"'&[email protected] i&' !& 1" &ni c&nt&'este &/'o0i9&ti+ 1,,5

    12,'&9e.Rinichi! &8!t!i 9&so&'> "5c9. [email protected] !&)i9e& 8e [email protected]"c9. *i 'osi9e& 8e 2 c9.

    1.1..!uloare. !onsistent .C!o&'e& 'inichi!i este 'o*ie ='n>@ i&' consisten)& este 8est! 8e 7e'9> c& s> !&sei9/'esini /e s/!in& si7ic&t..

    P&'enchi9! [email protected] [email protected] 7'i&[email protected] 8eo&'ece se '/e 'e1&ti+so' int'&9&tis9.1.1.".Delimitare

    Rinichii snt 8e!i9it&)i n ss 8e !ini& o'i(ont&!> ce t'ece /'in co'/! +e'te='ei [email protected] 9e8i&!8e +e'tic&!& ce t'ece /'in +?'7! /'ocese!o' t'&ns+e's&!e &!e +e'te='e!o'@ n Hos 8e o'i(on&!&t'ece !& 8o> !&)i9i 8e 8eet n &7&'& 9*chi!o' 9&sei !o9=&'e co9ne. 3e [email protected] 'inichi!8'e/t este sit&t c 152c9 9&i Hos 8ec?t ce! [email protected] i&' ce! st?n este sit&t c [email protected]"54c98e&s/'& c'este!o' i!i&ce 'inichi! n este /&!/&=i!.1.1..#.. $o%a renala

    Rinichii snt sit&)i n s/&)i! 'e/t'o/e'itone&! 9/'en> c !&n8e!e s/'&'en&[email protected]/&nc'e&[email protected] o /&'te 8in [email protected] co!on! &scen8ent * i [email protected] +&se!e 9&'i &o't&@+en& c&+>in7e'io&'>[email protected] c&n&!! to'&cic *i 'et'e!e.

    :n &cest s/&)i este sit&t> !oH& 'en&!& c&'e /'e(int> n9e'o&se !i9ite s/e'io'8i&7'&9!

    9e8i&! *i co!o&n& +e'te='&!> /oste'io' *i !&te'&! /e'ete!e to'&cic *i 9*chii !o9=&'i.est! conHcti+ !&0 c&'e oc/> s/&)i! e0t'&/e'itone&! 7o'9e&(> n H'! 'inichi!i n

    n+e!is 7i='[email protected] 8ens *i 'e(istent 8en9it 7&scie 'en&!>. Acest> 7&scie &'e 2 7oi)e 7oi)&/'e'en&!> *i 7oi)& 'et'o'en&!> D. :nt'e ce!e 2 57oi)e e0ist> n st'&t '&[email protected] 7!i8 n9it c&/s!>&8i/o&s> '>si9e& /enten&!>@ st'&t & c>'i 'osi9e 8e/in8e 8e +?'st& *i st&'e& 8e nt'i)ie &s=ict!i.

    :nt'e 7oi)& 'et'o'en&!> *i 9schi! />'t&t &! 1o9=e!o' *i i!o/so&s se >se*te n &!t st'&t&8i/os 8en9it '&si9e& /&'&'en&!> Ge'ot&.Rinichi! 8'e/t este n '&/o't c 7!e0'& co!ic> 8'e/t&@ /o'tine& & 8o& & 8o&8en!i *i

    7&)& +isce'&!> & !o=!i 8'e/t he/&tic.Rinichi! st?n &'e 7&)& &nte'io&'> i9/&')it> n t'ei se9ente s/'&co!ic s/e'io'[email protected]

    co!ic 9iH!ociD *i s=co!ic in7e'io'D.e9ent! s/'&co!ic &'e '&/o't'i c s/!in&@ co'/! /&nc'e&s!i *i sto9&c.e9ent! co!ic +ine n '&/o't c /&'te& st?n> & co!on!i t'&ns+e's *i c 9e(oco!on! s>.e9ent! s=co!ic &'e '&/o't'i & &nse!e HeHn&!e.Fe)e!e /oste'io&'e & '&/o't'i &se9>n>to&'e /ent' &9=ii 'inichi.e9ent! 8i&7'&9&tic +ine n '&/o't c 8i&7'&9! *i /'in inte'9e8i! s> c

    'eces'i!e c&sto58&7'&9&tice &!e /!e'e!o' c /!>[email protected] co&ste!e & ! !5& *i & 125& s/&)iinte'cost&!.

    e9ent! !o9=&' &'e '&/o't'i c />')i!e 9oi &!e 'einii !o9=&'[email protected] c/'inse nt'e co!o&n>@co&st& & 125& *i c'e&st& i!i&c&.

    M&'7ini!e !&te'&!e5 n 8'e&/t&@ &'e '&/o't'i c 7&)& +isce'&!> & 7ic&t!i *i c co!on! &scen8ent.5 n st?n&@ c 7&)& 'en&!> & s/!inei *i c co!on! 8escen8ent.5 M&'ine& 9e8i&!&5 se9ent! s/'&hi!&' este n '&/o't c c&/s!& s/'&'en&!>5 se9ent! in7'&hi!&' este n '&/o't c 'et'e!e

    E0t'e9it>)i!e s/e'io&'e snt n '&/o't !&n8e!e s/'&'en&!e *i 8i&7'&[email protected] i&' /ent''inichi! st?n *i c s/!in&.E0t'e9it>)i!e in7e'io&'e snt n '&/o't c 9*[email protected] />t'&t! !o9=e!o' *i i!i/so&s.

    #

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    C>i!e e0c'eto'ii &!e 'inichi!i snt 7o'9&te 8in c&!ice!e 9ici si 9&'[email protected] =&(inet s& /e!+is'en&[email protected] 'ete'[email protected] +e(ic& 'in&'> *i 'et'&.1.1.1&.!ile excretoare ale rinichiului

    A'te'e!e inte'!o=!&'e snt s's& &'te'io!e!o' &7e'ente ne!e &'te'io!e &7e'[email protected] /ot /!ec&8i'ect 8in &'te'e!e &'c&teD. Aceste&@ /&t'n8 n co'/sc!ii 'en&!i !& ni+e!! hi!!i !o9e'!&' si7o'9e&(& !o9e'!ii 'en&!i. Anse!e !o9e'!&'e se concent'e&(& n 7in&! n &'te'io!& e7e'ent&@c&'e /&'&seste !o9e'!! !& ni+e!! hi!!i si se 'ec&/i!&'i(e&(& n H'! t=i!o' 'en&!i.

    3in &'te'e!e 'en&!e se 8es/'in8 '&9'i /ent' !&n8& s/'&'en&!& n& s& 9&i 9!te&'te'e s/'&'en&!e in7e'io&'[email protected] c&/s!& 'en&!&@ /&'te& s/e'io&'& & 'ete'!i si '&si9e&

    /e'ine7'etic&. R&9'i!e c&/s!&'[email protected] se /ot &n&sto9o(& c '&9'i &!e &'te'e!o' s/'&'en&[email protected] enit&!esi !o9=&'e.

    An&to9istii & i8enti7ic&t o (on& c +&sc!&'i(&tie 9&i s&'&c& /&ci+&sc!&'&D nt'5n/!&n 'e!&ti+ 7'ont&! c&'e t'ece !& ,@"c9 /oste'io' s&nt!i !onit8in&! 8e /e 9&'ine& !&te'&!& &'inichi!i !ini& /&ci+&sc!&'& & !i Q'[email protected] /!&n ce &' /te& 7i 7o!osit n chi''i& 'en&!& /ent'&cces !& c&!ice.

    .2. V'/('&)1',)' ) )%$&3',)'1.2.1.'asculari(atia )enoasa3in 'ete&& c&/i!&'& /e'it=!&'& si 8in 'ete&& /e'i7e'ic& +eno&s& s=c&/s!&'& s?ne!e

    +enos este 8'en&t n +ene!e inte'!o=!&'e c&'e nsotesc &'te'e!e c &ce!&si [email protected] te'9in?n85se n+ene!e &'c&te sit&te !& =&(& /i'&9i8e!o' M&!/ihi +&sc!&'i(&ti& +eno&s& n este 8e ti/te'9in&! c& ce& &'te'i&!& D.

    L& ni+e!! co!o&ne!o'

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    Pe!+is! 'en&! =&(inet!D este o 7o'9&tine 9sc!o59e9='&no&s&@ 8i!&t&t&@ 'e(!t&t& /'inni'e& c&!ice!o' 9&'i. Este 7'ec+ent co9/&'&t c o /?!nie t'tit& &nte'o5/oste'io'.Fo'9& si9&'i9e& =&(inet!i 8e/in8 8e 9o8! 8e ni'e si 8i9ensini!e c&!ice!o'. A+?n8 o 7o'9&t'inhi!&'& 8e /?!nie t'tit& &nte'o5/oste'io'@ =&(inet! /'e(int& o 7&t& &nte'io&'& si n&

    /oste'io'&@ o =&(& s/'e c&'e con+e' c&!ice!e 9&'i si n +?'7 c&'e se contin& c 'ete'!.

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    'in&'[email protected] 'ete'! este [email protected] /ent' o /o'tine 8e [email protected]" [email protected] 8e &'te'& te'in&@ c&'e &/oi t'ece&nte'io' 8e 'ete' /ent' & 'c& nt'e ce!e 8o& 7oite &!e !i&9ent!i !&t.

    %&sc!&'i(&ti& 'ete'!i. U'ete'! este i'i&t 8e '&9'i 8in &'te'& 'en&!&@ s/e'9&tic& inte'n&@hi/o&st'ic& si +e(ic&!& in7e'io&'&. %ene!e 'e&!i(e&(& n siste9 &nosto9otic nt'e +en& 'en&!&st?n& si +ene!e i!i&ce inte'ne.

    Ine'+&ti& 'ete'!i 8e'i+& 8in /!e0! 9e(ente'ic in7e'io'@ s/e'9&tic si /e!+in.Li97&tice. :n &n!ionii !&te'o&o'tici 8'ene(& ce!e 8o& t'ei9i s/e'io&'e &!e 'ete'[email protected] i&'

    !i97& /o'tinii /e!+ine 8'ene&(& n &n!ionii i!i&ci inte'[email protected] &n!ionii i!i&ci e0te'ni si i!i&cico9ni.

    3e(+o!t&'e& 'ete'!i co'es/n8e ce!ei 8e & t'ei& et&/e 8in 8e(+o!t&'e& '[email protected] &8ic&9et&ne7'os!. E! &'e 8o& co9/onente 8eistincte =!&ste9! 9et&ne7'oen si 9'e!e 'ete'&!con8itione&(& 7o'9&'e& 'inichi!i 8e7initi+D.

    U'ete'! este 7o'9&t 8in t'ei tnici &8+entice&@ 9sc!&'& si 9co&s&.&D A8+entice&@ !& e0t'e9it&te& s/e'io&'&@ se contin& c 7&sci& 'en&!&@ i&' !& c&/&t! o/s se

    /ie'8e in &8+entice& +e(icii 'in&'e.

    =D Tnic& 9sc!&'& este 7o'9&t& 8in t'ei st'&t'i !onit8in&! e0te'[email protected] ci'c!&' si !onit8in&!inte'n.:n /'tine& in7e'io&'& & 'ete'[email protected] nt'e st'&t! ci'c!&' si ce! !onit8in&! inte'[email protected] se &seste o

    'ete& c&/i!&'& si +eno&s&@ =ine 'e/'e(ent&t&@i&' !& ni+e!! Honctinii 'ete'o+e(ic&[email protected] 8is/&' 7i='e!eci'c!&'e.

    cD Mco&s& este 7o'9&t& 8in 5 'ote!i /e sectine t'&ns+e's&!& 8& n &s/ect ste!&t !9en!i este /!'ist'&ti7ic&[email protected]

    ce!!e!e e/ite!i&!e snt 8e ti/ 9&!/ihi&[email protected] ce!e s/e'7ici&!e /t?n85se 8esc&9&. 5co'ion contine +&[email protected] ne'+i si ins!e 8e test !i97&tic.Ro!! 'ete'!i este &ce!& 8e & t'&ns/o't& 'in& 8e !& 'inichi !& +e(ic& 'in&'&@ /'in 9isc&'i

    /e'ist&!tice. Misc&'i c&'e & 8'e/t consecint& c'este'e& /'esinii int'&'et'&!e ce +& 8ce n 7in&!

    !& 8eschi8e'e& o'i7ici!i 8e in'&'e n +e(ic& c t'ece'e& 'inii in +e(ic& 'in&'&. Pe'ist&!tis9!este &si'&t 8e ce!!e!e /&ce9&e' sit&te !& ni+e!! =&(inet!i. Aceste ce!!e c &to9&[email protected]'e&(& /otenti&!e 8e &ctine c&'e st& !& =&(& cont'&ctiei 8e ti/ /e'ist&!tic. Cont'&ctii!e & o7'ec+ent& 8e 15#S9in si snt sti9!&te /'in 9ec&nis9 9ioen n '9& c'este'ii +o!9!i 'in&'8in t=. Tons! si /e'ist&!tis9! snt s= cont'o!! siste9!i ne'+os +eet&[email protected] &st7e! ne'+!hi/o&st'icN%D sc&8e tons! si /e'ist&[email protected] i&' ne'+! +&N%PD !e c'este.

    Re7!0! +e(ico5'ete'&! este 9/ie8ic&t 8&to'it& cont'&ctiei 8et'so'!i c&'e co9/'i9&/o'tine& int'&9'&!& & 'ete'!i.

    U'ete'! este n con8ct c&'e t'&ns/o't& 'in& 8e !& 'inichi !& +e(ic& 'in&'&.A'e o !ni9e8e 2"5-, [email protected] t'&iect 'ecti!ini

    si c&!i=' neni7o'[email protected] /'e(ent?n8 t'ei (one nst&te

    5 Honctine& /ie!o'ete'&!& co!! 'ete'!iD 5 7!e0'& 9&'in&!& 5 Honctine& 'ete'o+e(ic&!&

    1.2.5.'e(ica urinarae9ent 8i!&t&t &! c&i!o' 'in&'e in7e'io&'e n c&'e se &c9!e&(& 'in& nt'e 9ictini. C& si

    !oc&!i(&'[email protected] +e(ic& 'in&'& este sit&t& n /[email protected] e0t'&/e'itone&[email protected] n !oH& +e(ic&!& si n 7nctie 8e'&8! 8e /!entit8ine &'e '9&to&'e& con7i'&tie =&(& +e(icii s& 7n8! si co!! 'e/'e(int&

    /o'tine& 7i0& & +e([email protected] n ti9/ ce co'/! si +?'7! &/e0D /o'tine& 9o=i!&.%e(ic& 'in&'& &'e o'iine 8=!& en8o8e'9&!& c&'e i& n&ste'e 8in /o'tine& c'&ni&!& &

    sins!i 'oenit&! si 9e(o8e'9&!& 'e/'e(ent&t& 8e /&'te& te'9in&!& & c&n&!e!o' 9e(one7'oticeVo!77D.

    %e(ic& 'in&'& este 7o'9&t& 8in t'ei [email protected] c&'[email protected] 8ins/'e e0te'io' s/'e inte'io'@ snt

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    Tnic& e0te'n& se'o&8+entice&D. F&t& /oste'o5in7e'io&'&@ /oste'o5s/e'io&'& si /&'te&s/e'io&'& & 7ete!o' !&te'&[email protected] snt &co/e'ite 8e se'o&s&@ 'est! +e(icii este n+e!it& 8e &8+entice.

    Tnic& 9c!&'&. 3et'so'! +e(ic&! este 7o'9&t 8in 7i='e 9sc!&'e nete8e 8is/se n t'eist'&t'[email protected] c&'e 8esc'i n t'&iect s/i'&!&t !onit8in&! e0te'[email protected] ci'c!&' [email protected] c&'[email protected] !& ni+e!!co!!i +e(ic&[email protected] 7o'9e&(& 9schi! s7incte' 'et'&! inte'[email protected] si !onit8in&! inte'n s& /!e0i7o'9 sicont'i=ie !& 7o'9&'e& 8i+e'tic!i!o' +e(ic&!i 8o=?n8iti n c&( 8e o=st'ctie +e(ic&!&D. L& &cestni+e! se 9&i 8esc'ie t'ion! +e(ic&! s/e'7ici&! si ce! /'[email protected] ce! 8in '9& inte'+ine n sc't&'e&8et'so'!i n contenti& +e(icii si nchi8e'e& osti!i 'ete'&! inte'n.

    Tnic& 9co&s&. Este 7o'9&t& 8in 5 'ote!i5 7o'9&t 8in "5 st'&t'i 8e [email protected] ce!e 8e !& s/'&7&t& 9='e!i7o'9eD &si'&

    i9/e'9e&=i!it&te& 'ote!i!i /ent' s=st&nte!e 8in 'in& si /'e(int& !& ni+e! /!&s9&!e9&! Jco'/ii [email protected] 'es/ons&=i!i 8e &!ni'e& 9e9='&nei ce!!&'[email protected] c?n8 +e(ic& este n st&'e 8e

    /!entit8ine. 5 co'ion5 contine o 'ete& +&sc!&'&@ 7i='e ne'+o&se si '&'i no8!i !i97&tici. Este &!c&tit

    8in test conHncti+ !&0 e0ce/tie t'ion! +e(ic&! test conHncti+ 8ensD c&'e /e'9ite/!ic&t'&'e& 9co&sei +e(ic&!e.

    %e(ic& 'in&'& n8e/!ineste 7ncti& 8e &c9!&'[email protected] contentie si e+&c&'e & '[email protected] e+&c&'e'e&!i(&t& c &Hto'! 'et'ei. Co9/o(iti& 'inei c9!&t& n +e(ic& &'e &cee&si co9/o(itie c& sice& 8in 8cte!e co!ecto&'[email protected] /'in '9&'[email protected] n snt 9o8i7ic&'i i9/o't&[email protected] n cee& ce /'i+esteco9/o(iti&@ 8e5&!n! t'&se!i c&t'e +e(ic&.

    U'in& c&'e t'ece 8in 8cte!e co!ecto&'e in c&!ice!e 'en&[email protected] 8ete'9in& sti9!&'e& ce!!e!o' /&ce59&e' 8e !& &cest ni+e! c initie'e& n8e!o' /e'ist&!tice 8e cont'&ctie c&'e se +o' '&s/?n8i n tott'&se! 'ete'!i. Acest !c' este 'es/ons&=i! 8e t'ece'e& 'inei 8in /e!+is! 'en&! n +e(ic&.

    U'ete'! int'& n +e(ic& 'in&'& !& ni+e!! t'ion!i +e(ic&! st'&=&t?n8 9schi! 8et'so' /eo /o'tine 8e c?ti+& [email protected] c o 8i'ectie o=!ic&. Tons! no'9&! &! 9schi!i 8et'so' tin8e s& 8c&!& o co9/'esie & 'ete'[email protected] &st7e! c& 'in& s& n 'e'ite(e n sens o/s n 9o9ent! n c&'e

    /'esine& 8in +e(ic& c'[email protected] 8o&' c& n 9o9ent! 8ec!&ns&'ii n8e!o' /e'ist&!tice /'esine 8in

    'ete'e c'este 8ete'9in?8 8eschi8e'e& osti!i si t'ece'e& 'inei n +e(ic&.L& ne!e /e'so&[email protected] t'&se! 'ete'!i /'in 9schi! 8et'so' este 9&i [email protected] &st7e! c&@ n9o9ent! n c&'e &'e !oc 9ictine&@ osti! 'ete'!i n9&i este s7icient co9/'i9&t. C& si'e(!t&[email protected] o 9ic& c&ntit&te 8e 'in& este /'o/!s&t& n sens in+e'[email protected] n 'ete'@ con8itie n9it& 'e7!0+e(ico'ete'&!. Acest 'e7!0 se /o&te so!8& c e7ecte 8&n&to&'e &s/'& '[email protected] si &n9e8i&9et'! 'ete'!i c'[email protected] i&' n c&('i 9&i se+e'e c'este si /'esine& 8in c&!ice!e 'en&! c&7ect&'e& 9e8!&'ei.

    Pent' & /te& n'eist'& 9o8i7ic&'i!e 8e /'esine n '&/o't c '&8! 8e /[email protected]!i(&9 cisto9et'o'&9&. [email protected] c?n8 n +e(ic& n &+e9 'in&@ /'esine& int'&+e(ic&!& este ,@8&' n 9o9ent! n c&'e s5& &c9!&t o c&ntit&te 8e -,5", 9! 8e 'in&@ /'esine& c'este !& "51,c9 2O. :n /[email protected] 8&c& se 9&i &c9!e&(& n &8&s 8e 2,,5-,, 9! 'in&@ /'esine& n 9&i

    s7e'& 9o8i7ic&'i 8'&stice. Ace&st& c&/&cit&te 8e & 9entine /'esine& const&nt& se 8&to'e&(&tons!i int'insec &! /e'ete!i +e(ic&!.Peste !i9it& 8e -,,54,,@ /'esine& ns& c'este '&/i8.

    L& o /'esine ce co'es/n8e !& 4,, 9! 'in&@ &/&' cont'&ctii 'it9ice /ent' [email protected] 8&'cont'o!! s7incte'!i e0te'n 9/ie8ic& 9ictine&. Li9it& 8e 'e(istent& & s7incte'!i e0te'n este!& o /'esine 8e , c9 2Ono'9&! n +e(ic& se &c9!e&(& ",,5,, 9! 'in&@ 7&'& s& se &Hn&!& 8istensie 8'e'o&s&D.1.2.6. *retra

    U'et'& este n con8ct /'in inte'9e8i! c&'i& 'in& 8in +e(ic& 'in&'& este e0/!(&t& !&e0te'io'. 3i7e'& 8e !& n se0 !& &[email protected] &st7e! !& 7e9eie se'+este n9&i c& o'&n 'in&'@ n ti9/ ce !&

    =&'=&t este n 8ct 9i0t enito5'in&'.U'et'& 9&sc!in&:si ince/e t'&se!n 7o'9& 8e it&!icD 8e !& ni+e!! o'i7ici!i 'et'&! &! +e([email protected] /ent' & se

    8eschi8e !&

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    e0te'io' /'in 9e&t! 'in&'osti 'et'&! e0te'nD 8in +?'7! !&n8!i.P'e(int&58o& c'='i5 /&t' /o'tini nst&te si t'ei /o'tini 8i!&t&te 8e !& e0te'io' s/'e inte'io'D 5 9e&t! e0te'n s& o'i7ici! e0te'n st'?9to&'e e!i/tic& 5 7os& n&+ic!&'& 8i!&t&'e o+oi8&!& 5 n co'/! s/onios st'?9to&'e !n& 5 7n8! 8e s&c &! =!=!i 8i!&t&'e &ccent&t& 5 n /o'tine& 9e9='&no&s& st'?9to&'e ci!in8'ic& 5 sins! /'ost&tic 8i!&t&'e 5 o'i7ici! inte'n &! 'et'ei st'?9to&'e ci'c!&'& 5 t'ei /o'[email protected] 8/& o'&ne!e /e c&'e !e t'&+e'se(& &D 'et'& /'ost&tic&t'&=&te /'ost&t& 8e !& =&(& s/'e +?'7 si este /&'te& ce& 9&i 8i!&t&t&. A'e n t'&se &/'o&/e

    +e'tic&[email protected] n /&'te& s& s/e'o&'&@ 7iin8 9&i &/'o&/e 8e 7&t& &nte'io&'&@ i&' in7e'io' e& este 9&i&/'o/i&t& 8e 7&t& /oste'io&'& & !&n8ei. Pe'ete!e /oste'io' &! 'et'ei /'e(int& o /!ic& !onit8in&!&@

    n9it& c'e&st& 'et'&!&@ c&'e se ntin8e 8e !& co!! +e(icii /?n& !& /o'tine& 9e9='&no&s&.Co!ic!! se9in&! este /nct! ce! 9&i /'oe9inent &! c'[email protected] si se &7!& !& H9&t&te& !ni9ii [email protected]&' 9/'en& 7o'9e&(& cee& ce se n9este +e'9 9ont&n9. Acest co!ic! 9/&'te 'et'&

    /'ost&tic& n 8o& se9ente s/'&i&[email protected] c 'o! n e0/!(i& '[email protected] si s=i&cent c 'o! co9n/ent' e0/!(i& 'inii c?t si & s/e'9ei.

    :n +?'7! co!ic!i se9in&! se 8eschi8e t'ic!! /'ost&tic+estii &! 8ct!i/&'&9e(one7'ic MW!!e'D si /e /&'ti!e !&te'&!e &!e &cesti&@ o'i7icii!e 8cte!o' eH&c!&to&'e. 3e o/&'te si 8e &!t& & c'estei 'et'&!e se &7!& sins'i!e /'ost&tice n c&'e se &sesc o'i7icii!e 8e8eschi8e'e &! 8cte!o' /'ost&[email protected] i&' in7e'io' 8e co!ic!! se9in&[email protected] se =i7'c& n 8o& cte9co&se n9ite 7'?'i!e c'estei 'et'&[email protected] c&'e se /ie'8 &/oi /e /e'ete!e /oste'io' &! 'et'ei9e9='&no&se.

    =D 'et'& 9e9='&no&s&Este c/'ins& nt'e +?'7! /'ost&tei si 7&t& s/e'io&'& & =!=!i s/[email protected] i&' /ent' c&st'&=&te 8i&7'&9& 'oenit&!&@ 8e c&'e &8e'&@ i se 9&i s/ne si 'et'& 8i&7'&9&tic&. L& &cestni+e! 'et'& este conH'&t& 8e 9schi! s7incte' 'et'&! e0te'n si 8e ce!e 8o& !&9e &!e 7&sciei

    /e'ine&!e 9iH!ocii. :n&inte 8e & /e'7o'& 8i&7'&9& 'oenit&!&@ 'et'& 9e9='&no&s& t'ece !& n 1c9 in7e'io' 8e si97i(& /=i&n& si 8e !i&9ent! &'c&t &! /=e!i. Ante'io' &'e '&/o't c +en&8o's&!& /'o7n8& & /enis!isit&t& nt'e !i&9ent! &'c&t si !i&9ent! t'&ns+e's &! /e'[email protected]&' /oste'io' c 9schi! t'&ns+e's /'o7n8 &! /e'[email protected] 9schi! s7incte' 'et'&! e0te'[email protected]! 'ecto'et'&[email protected] !&n8e!e =!=o'et'&!e M&'Q5Coo/e'. Aceste '&/o't'i e0/!ic& 9ec&nis9!8e '/e'[email protected] /'in J7o'7ec&'[email protected] & 'et'ei n t'&9&tis9e!e /e!+ine. Este /o'tine& ce& 9&i /tin9o=i!& si ce& 9&i st9t& & nt'eii 'et'[email protected] 8&' /o&te 7i 8i!&t&=i!&.

    cD 'et'& s/onio&s& /eni&n&DP&t'n8e n co'/! s/onios /e 7&t& s& s/e'io&'&@ schi9=?n85si 8i'ecti& 8e !& +e'tic&! s/'e

    &nte'io' si s/e'io'. Re(!t& c& 'et'& !& &cest ni+e! n +& 7i &co/e'it& 8e test e'[email protected] 7iin8 n/nct s!&= n c&'e se /ot /'o8ce /e'7o'&tii s/ont&ne. Pe /e'ete!e /oste'io' se &sesc o'i7icii!e!&n8e!o' =!=o'et'&!e CoK/e'@ n n9&' 8e 8o&. 3ist&[email protected] !& ni+e!! !&n8!i /eni&[email protected] 'et'&

    /'e(int& o 8i!&t&tie n9it& 7os& n&+ic!&'&. E& este 8e!i9it&t& s/e'io' 8e +&!+!& 7osei n&+ic!&'es& +&!+!& !i Ge''[email protected] n /!i &! 9co&sei 'et'&[email protected] c&'[email protected] 9/'en& c /e'ete!e s/e'io' &! 7osein&+ic!&'e 8e!i9ite&(& sins! Ge''in. Acest sins /o&te constiti n o=st&co! n ti9/!c&tete'is9!i 'ete'&!. Me&t! 'in&' s& osti! 'et'&! e0te'n se &7!& !& ni+e!! !&[email protected] n+?'7! &cesti&@ 9&i &/'o&/e 8e 7&t& !i 'et'&!&@ si &'e &s/ect 8e 7&nt& +e'tic&!& c&'e 8e+inee!i/tic& n 9ictine.

    U'et'& 7e9inin&.

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    :nce/e /'in o'i7ici! inte'n &! 'et'ei si se te'9in& !& e0te'io' /'in o'i7ici! e0te'n &!'et'ei9e&t! 'in&'5 !& 9&'ini!e !i se &7!& ce!e 8o& /&/i!e 'et'&!eD. T'&iect o=!ic in7e'io' si&nte'io'.

    P'e(int& 8o& se9ente5/e!+inR&/o't /oste'io' c +&in&@ &nte'io' c /!e0! +enos +e(ico5+&in&[email protected] +en& 8o'&s&!& /'o7n8&

    & c!ito'[email protected] !i&9ente!e /=o+e(ic&[email protected] si97i(& /=i&n&@ i&' !&te'&! c 9. 'i8ic&to' &n&[email protected] 7&sci&s/e'io&'& & 8i&7'&9ei /e!+ine si /&'te& !&te'&!& & /!e0!i +enos &nto'ini.

    5 /e'ine&!R&/o't &nte'io' c !i&9ent! t'&ns+e's &! /e'ine!i si +en& 8o's&!& /'o7n8& & c!ito'[email protected]

    /oste'io' c se/t! 'et'o+&in&[email protected] !&te'&! c 9schi! 'i8ic&to' &n&!. = 8i&7'&9& 'oenit&!&@'et'& &'e '&/o't c 9schii =!=oc&+e'onsi si co'/ii c&+e'nosi &i c!ito'is!i.

    e9ente!e 'et'ei 9&sc!ine & o'iine e9'io!oic& 8i7e'it& 'et'& /'ost&tic& este 8eo'iine en8o8e'9&!&@ 'et'& s/'&9ont&n&!& /'o+ine 8in /o'tine& 'et'&!& & sins!i 'oenit&!

    /'[email protected] c&'e !& 7e9eie 'e/'e(int& /'i9o'8i! 'et'ei. 3o&' /e'ete!e /oste'io' &! 'et'eis/'&9ont&n&!e ete 8e o'iine 9e(o8e'9&!&@ /'o+ine 8in 8ct! 9e(one7'otic Vo!77.

    U'et'& 9&sc!in& &'e 7nctie 8=!& &si'& t'&ns/o't! 'inii 8e !& ni+e!! +e(icii 'in&'e!& e0te'io'@ 8&' 9&i s!Heste si /ent' e0/!(&'e& s/e'9ei n ti9/! eH&c!&'ii.P&'tic!&'it&ti!e st'ct'&!e &!e 'et'ei snt ce!e c&'e i &si'& 7ncti& 8e con8ct

    'in&'@ 7&ci!it?n8 t'ece'e& '[email protected] e!e snt59co&s& 7o&'te e!&stic&@ c&'e /o&te 7i 8estins& c s'int& !& tece'e& 'inii

    59cs! sec'et&t 8e !&n8e!e 'et'&[email protected] c&'e !='e7i&(& s/'&7&t& 'et'ei5 /!e0 +enos contint n co'[email protected] c&'e se o!este n ti9/! [email protected] !&'in8 !9en!

    c&n&!!i.:n 7&(& eH&c!&to'ie & &ct!i se0&[email protected] s7incte'! nete8 +e(ic&! si s7incte'! /'e/'ost&tic se

    cont'&ct& /'o'[email protected] &st7e! c& 'et'& /'ost&tic& s/'&9ont&n&!& se [email protected] n ti9/ ce 'et'&s=9ont&n&!& se 8i!&t& conco9itent c 'e!&0&'e& s7incte'!i st'i&t. A9=e!e s7incte'e 9/ie8ic&

    s/e'9& s& &Hn& n +e(ic&@ i&' o 8e7icient& in cee& ce /'i+este n8e/!ini'e& &cestei [email protected] /o&teconstiti o c&(& 8e in7e'ti!it&te.T'escent& test!i c&+e'nos 8in st'ct'& co!ic!!i se9in&[email protected] cont'i=ie si e! !&

    nchi8e'e& 'et'ei n ti9/! e'ectiei 9/e8ic?n8 &scensine& !ichi8!i se9in&! s/'e +e(ic&@8&' si&cces! 'inii n 8cte!e eH&c!&to&'e.

    5 Citosco/i&+e(i +e(ic& 'in&'&5 E0&9en 9ic'osco/ic &! sec'et!i 'et'&!5 U'et'o'&7ie. Uti!& /ent' e0/!o'&'e& st'icti!o' 'et'&[email protected] 8&' si /ent'

    e+i8entie'e& t9o'i!o' 'et'ei.5 U'o'&7i& int'&+eno&s&. In8ic&t& n /e't'=&'i e0c'eto'ii /'in

    'et'&. Este cont'&in8ic&t& /e'so&ne!o' c hi/e'sensi=i!it&te !& [email protected] c ins7icient& 'en&!&@

    he/&tic& si c&'8i&c&@ c &ne9ie he9o!itic&@ st&'i 7e='[email protected] s&'cin&.

    .4.F)1)5(56)' '7'&'*/(/) $8&$*5&1.3.1. Generalit+i

    Este /'oces! 7i(io!oic c&'e se 'e&!i(e&(> !& ni+e!! 9&i 9!to' o'&[email protected] &si'?n8 e!i9in&'e&s=st&n)e!o' ne7o!osi=i!e 8in co'/@ n& 8int'e 7o'9e!e 8e e0c'e)ie este *i ce& 'e&!i(&t> !& ni+e!!siste9!i e0c'eto'5'in&'.

    Fo'9&)ini!e &n&to9ice c&'e cont'i=ie !& /'o8ce'e& *i e!i9in&'e& 'inei 7o'9e&(> siste9!e0c'eto'@ este o +e'it&=i!> 9&*in> /ent' e/'&'e&c'>)&'e&@ /'i7ic&'e&D co'/!i. E! e0t'&e8e*e'i 8in s?ne *i !e e!i9in> n 'in>@ &ce&st> o/e'&)ine 8e e/'&'e /'i7ic&'eD se e7ecte&(>n 'inichi.

    U'in& se sc'e &/oi /'in 8o& c&n&!e n9ite 'ete'[email protected] /?n> !& +e(ic& 'in&'>. O8&t> /!in>@&ce&st& +e(ic& 'in&'>[email protected] e+&ce&(> !ichi8! /'int'5n c&n&! n9it 'et'>.

    14

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    1.3.2. Formarea uriniiU'in& !&tin>'in&D este n !ichi8 7o'9&t 8int'5n &9estec 8e s=st&n)e e!i9in&te 8in

    o'&nis9! +e'te='&te!o'.E! se 7o'9e&(> n 'inichic&'e Ho&c> o 7nc)ie 8e 7i!t'&'e & [email protected] &ici'in& /'i9&'> +& 7i 'e7i!t'&t> *i &Hne /e c>i!e 'in&'e 'ete'eY n +e(ic& 'in&'>c&'e !& o9 &'e oc&/&cit&te 8e c&. [email protected]" !it'[email protected] 8e n8e 'in& este e!i9in&t> n e0te'io' 9ic)ineD /'in 'et'>*io'&ne!e se0&!e e0te'ne. Fo'9&'e& *i e!i9in&'e& 'inei Ho&c> n 'o! i9/o't&nt n 'e!&'e&+o!e9iei s&[email protected] & echi!i='!i 8e e!ect'o!i)i *i e!i9in&'e& s=st&n)e!o' 8e 8e(&si9i!&'e 8in9et&=o!is9! /'oteine!o' c&'e snt to0ice. U'in& !& o9 &'e o c!o&'e &!=en>@ c!o&'e& *icon)int! 'inei 7iin8 n in8ic&to' +&!o'os !& 8e/ist&'e& &! no' =o!i /'in e0&9ene 8e !&=o'&to'.

    L& o9 *i !& &ni9&!e!e +e'te='&te n ene'&! 'in& este n !t'&7i!t'&t &! /!&s9ei s&nine c&'e&'e !oc !& ni+e! 'en&!. ?ne!e t'&+e'se&(> co'/sc!ii 'en&!i Co'/sc!& 'en&!i&D. =st&n)e!ehi8'oso!=i!e c o 9>'i9e 9o!ec!&'> s= [email protected] n&no9et'[email protected] /'int'e c&'e snt ionii *i9ic'o/'[email protected] +o' t'&+e's& 7i!t'! 8e !& ni+e!! co'/sc!io' 'en&[email protected] &Hn*i t=!ii 'en&!it=!sD &i ne7'on!i &cest 7i!t'&t 7iin8 n9it 'in> /'i9&'>Y e& con)ine ne!e s=st&n)ei9/o't&nte /ent' o'&nis9 c& !co(>@ &9ino&ci(i*i e!ect'o!i)i s=st&n)e 9ine'&!eD. Un o9&8!t /'o8ce /e (i nt'e 1#, 5 2,, !it'i 8e 'in> /'i9&'>. Ace&st> c&ntit&te 8e 'in> /'i9&'> +& 7i

    'e7i!t'&t> !& ni+e!! t=!i!o' 'en&!i /'o0i9&!i *i 8ist&!i [email protected] en!eD c&'e 7o'9e&(> [email protected] &ici+o' 7i 'ec/e'&te s=st&n)e!e neces&'e o'&nis9!i *i &/& nt'5n /'ocent 8e $$ . C&ntit&te& 8e'in> secn8&'> 'e(!t&t> +& 7i 8e cc&. 1 5 [email protected]" !it'i. , 9!So'>D. AHns> n =&(in! 'en&! 'in& +& 7it'&+e's& 'ete'e!e &Hn?n8 /'in ce!e 8o> 'ete'e n +e(ic& 'in&'> n8e +& 7i stoc&t>. 3in (ic&'in&'> +& 7i e!i9in&t> n e0te'io' /'in 'et'> c&'e se te'9in> n o'&ne!e se0&!e e0te'ne.P'oces! 8e sec'e)ie 'in&'> este n9it> 8i'e(>@ c&'e &'e !oc /'in 8i&!i(> 'en&!>. 3i'e(& estein7!en)&t> 8e +o!e9ie +o!9! s&ninD 8e /'esine& s?n8e!i c& *i 8e &c)ine& no' ho'9onis& & no' s=st&n)e 8i'etice c& *i co7ein&s& et&no!!c&'e intesi7ic> 8i'e(&.1.3.3. Filtrarea ,lomerulara

    F!0! s&n+in n se 8ist'i=ie ni7o'9 in int'e&& 9&s& 'en&!&. Co'tic&!& este 9&i =inei'i&t& &ti+ c 9e8!&'&.

    M&s'&'e& 7i!t'&'ii !o9e'!&'e este /osi=i!& c o s=st&nt& c&'e n se co9=in& c /'[email protected] nse 9eo!i(e&(& in test'i!e o'&[email protected] &'e 8i9ensini c&'e /e'9it 7i!t'&'e& !i=e'& si n este'eso'=it& nici sec'et&t& 8e c&t'e t=ii 'en&!i. Aceste c'ite'ii snt in8e/!inite in ce& 9&i 9&'e9&s'& 8e in!in&@ c&'e ins& este 8i7ici! 8e 9&s'&t. Pent' 8ete'9in&'e& 7i!t'&'ii !o9e'!&'e se&89inist'e&(& /'in /e'7(ie en8o+eno&s& o c&ntit&te 8e in!in& c&'e 'e&!i(e&(& si 9entine nni+e! s&n+in const&nt. Pent' c&!c!&'e& c!e&'&nce5!i in!inei se 9&so&'& concent'&ti& &cesteis=st&nte in 'in&[email protected] in /!&s9& PD si 8e=it! 'in&' %D CI in!inei se e0/'i9& in 9! ./!&s9&S9in.S92 si 9&so&'& e7icient& 7i!t'&'ii /'in !o9e'!c&ntit&te& 8e 7i!t'&t !o9e'!&'D. int'c&t concent'&ti& in!inei 8in /!&s9& sc&8e c 2, in8ec's! ni /&s&H 'en&[email protected] 'e(!t& c& !& n sin' ci'cit 'en&! se e!i9in& /'in 7i!t'&'e !o9e'!&'&2, 8in tot&!it&te& 7!0!i /!&s9&tic 'en&!. 3&c& s5&' ti!i(& /ent' c!e&'&nce o s=st&nt& c&'e in

    tot&!it&te &' 7i in8e/&'t&t& 8in /!&s9& /'int'5n sin' /&s&H 'en&[email protected] c& '9&'e & 9ec&nis9e!o'co9=in&te 8e 7i!t'&'e !o9e'!&'& si sec'etie t=!&'&@ +o!9! 8e /!&s9& 8e/'&t& 8e &ce&st&s=st&nt& &' 7i e&! c 7!0! /!&s9&tic 'en&!. L& co/i!! 9&i 9&'e si !& &8!t $" 8in &ci8!

    /&'&&9inohi/'ic PAD este e!i9in&t /'int'5n /&s&H 'en&[email protected] 8&' e!i9in&'e& PA5!i !& s&'este [ " si /'in '9&'e !& &ce&st& 'st& PA5! n /o&te 7i ti!i(&t /ent' 9&s'&'e& 7!0!i

    /!&s9&tic 'en&!. in /'&ctic&@ c'e&tinin& este ti!i(&t& /ent' 9&s'&'e& 7i!t'&'ii !o9e'!&'e.C'e&tinin& este in 9o8 no'9&! /'e(ent& in s&[email protected] se 9&so&'& so' si c!e&'&nce5! &cestei& estein8e/en8ent 8e 8e=it! 'in&'. /'e 8eose=i'e 8e in!in&@ c'e&tinin& se sec'et& si se 'e&=so&'=et=!&'. 3in &ceste 9oti+e 9&s'&'e& 7i!t'&'ii !o9e'!&'e /'in c!e&'&nce c'e&tininic este 9&i

    /tin e0&ct& &ti+ c c!e&'&nce5! in!inei.Fi!t'&'e& !o9e'!&'> [email protected] ce& 9&i &7ect&t> n c's! =o!i!o' &cte s& c'onice 8en9ite

    !o9e'!one7'ite s& !o9e'!o/&tii este 8e/en8ent> 8e c&ntit&te& 8e s?ne c&'e &Hne n!o9e'!i 7!0! s&nin !o9e'!&'[email protected] 8e /'esine& ce'e &cti+e&(> 8in inte'io'! c&/i!&'e!o'

    1"

    http://ro.wikipedia.org/wiki/Limba_latin%C4%83http://ro.wikipedia.org/wiki/Vertebratehttp://ro.wikipedia.org/wiki/Rinichihttp://ro.wikipedia.org/wiki/S%C3%A2ngehttp://ro.wikipedia.org/wiki/Vezica_urinar%C4%83http://ro.wikipedia.org/w/index.php?title=Uretr%C4%83&action=edit&redlink=1http://ro.wikipedia.org/wiki/Glucoz%C4%83http://ro.wikipedia.org/wiki/Aminoacizihttp://ro.wikipedia.org/wiki/Substan%C8%9Be_mineralehttp://ro.wikipedia.org/wiki/Cofeinahttp://ro.wikipedia.org/wiki/Etanolhttp://www.esanatos.com/ghid-medical/sanatatea-copilului/boile-aparatului-renourinar-la-copii/infecia-de-tract-urinar-itu82155.phphttp://www.esanatos.com/ghid-medical/sanatatea-copilului/rasfatul/e-posibil-s-rsfai-un-sugar22267.phphttp://ro.wikipedia.org/wiki/Limba_latin%C4%83http://ro.wikipedia.org/wiki/Vertebratehttp://ro.wikipedia.org/wiki/Rinichihttp://ro.wikipedia.org/wiki/S%C3%A2ngehttp://ro.wikipedia.org/wiki/Vezica_urinar%C4%83http://ro.wikipedia.org/w/index.php?title=Uretr%C4%83&action=edit&redlink=1http://ro.wikipedia.org/wiki/Glucoz%C4%83http://ro.wikipedia.org/wiki/Aminoacizihttp://ro.wikipedia.org/wiki/Substan%C8%9Be_mineralehttp://ro.wikipedia.org/wiki/Cofeinahttp://ro.wikipedia.org/wiki/Etanolhttp://www.esanatos.com/ghid-medical/sanatatea-copilului/boile-aparatului-renourinar-la-copii/infecia-de-tract-urinar-itu82155.phphttp://www.esanatos.com/ghid-medical/sanatatea-copilului/rasfatul/e-posibil-s-rsfai-un-sugar22267.php
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    !o9e'!&'e /ent' t'&ns7e'! nei />')i 8in /!&s9& s&n+in> n s/&)i! c&/s!&' /'esine& 8e!t'&7i!t'&'eD *i 8e s/'&7&)& tot&!> & c&/i!&'e!o' !o9e'!&'e /'in c&'e se 7&ce !t'&7i!t'&'e&.Re!&'e& &cesto' - /&'&9et'i se 7&ce /'in 9o8i7ic>'i contine &!e tons!i &'te'io!e!o' &7e'ente *ie7e'ente +&soconst'ic)ie +&so8i!&t&)ieD *i +&'i&)ii &!e st>'ii cont'&cti!e & ce!!e!o' 9e(&ni&!e.Aceste 9o8i7ic>'i 8e tons *i cont'&cti!it&te snt !& '?n8! !o' in7!en)&te 9o8!&teD 8e 7&cto'ine'oh9o'&!i ne'+o*[email protected] 8e 'e!> 'e7!ec*iD *i 9o'&[email protected] 8e 'e!> en8oc'[email protected] 8e 'e7!e0e9iente'ice /nct 8e /!ec&'e n ce!!e!e 9sc!&'e nete8eD !oc&!e *i s=st&n)e +&so&cti+econst'icto&'e s& 8i!&t&to&'[email protected] /'o8se 8e ce!!e!e en8ote!i&!e !o9e'!&'e o0i8 8e &([email protected]

    /'ost&cic!in>@ en8ote!in>D.Ace!e&*i ce!!e en8ote!i&!e /ose8> i9/o't&nte /'o/'iet>)i&ntit'o9=otice *i &nti&8e(i+e 7&)> 8e !ecocite *i t'o9=ociteD. 3&to'it> no' c&'&cte'istici 7i(ice 9>'i9e& 8eschi8e'i!o'@ & /o'i!o'Y 8int'e ce!!e!een8ote!i&!eD *i e!ect'ice nc>'c>t'& e!ect'ic> ne&ti+> 8in 9e9='&ne!e =&(&!e !o9e'!&'eD &!e

    /e'e)i!o' c&/i!&'e!o' !o9e'!&'[email protected] ce!!e!e s&n+ine *i 9&Ho'it&te& /'oteine!o' *i &!to' s=st&n)e c'et&te 9o!ec!&'> 9&'e n t'ec /'in /e'ete!e c&/i!&'@ &st7e! nc?t 'in& /'i9iti+> 'e/'e(int> n9&'e 9>s'> o /!&s9> 8e/'oteini(&t> &Hns> nt'5n s/&)i c&/s!&' 9en)int 8eschis 8e c>t'ece!!e!e e/ite!i&!e &!e c&/s!ei 9e9='&n& =&(&!> !o9e'!&'>D.O'ice &!te'&'e & st>'ii c&/i!&'e!o' !o9e'!&'e n c's! !o9e'!one7'ite!o' s& !o9e'!o/&tii!o'&7ecte&(> 7o'9&'e& [email protected] 'e)ine'e& n ci'c!&)ie & nei c&ntit>)i 8e !ichi8e *i s>''i *i 9o8i7ic&'e&'&8!i 8e /e'9e&=i!it&te & c&/i!&'e!o' !o9e'!&'e c &/&'i)i& n 'in> & /'oteine!o' *i ce!!e!o's&n+ine. 3e*[email protected] &8eseo'[email protected] n !i9=&H! 9e8ic&! o=i*nit te'9enii 8e !o9e'!one7'it> *i!o9e'!o/&tie snt 'e!&ti+ s/e'5/o(&[email protected] /'i9! /'es/ne e0isten)& in7!&9&)iei !o9e'!&'ein7i!t'&t !ecocit&'@ 8e/ne'i 8e &ntico'/i *i &cti+&'e 8e co9/!e9entD c&'e 8e 'e!> !i/se*te nc&(! s7e'in)e!o' !o9e'!&' nein7!&9&to'ii !o9e'!o/&tiiD. este consi8e'&t>

    /'i9&'> c?n8 !e(ini!e *i consecin)e!e !o' snt !oc&!i(&te e0c!si+ !& ni+e!! !o9e'!i!o' *isecn8&'> c?n8 &7ect&'e& !o9e'!e!o' este 8o&' n& 8int'e 8ete'9in>'i!e nei =o!i (ise

    9!tisiste9ice s& siste9ice.Te'9en! 8e &ct se 'e7e'> !& !e(ini!e *i consecin)e!e !o' c!inicec&'e se 8e(+o!t> n 8ec's 8e c?te+& (i!e s& s>/t>9?ni i&' ce! 8e s=&ct '&/i8 /'o'esi+D *ic'onic &tnci c?n8 este +o'=& 8es/'e !ni s& &ni.Le(ini!e !o9e'!&'e snt consi8e'&te 7oc&!ec?n8 inte'ese&(> 9&i /)in 8e ", 8int'e ne7'oni *i 8i7(e n ce!e!&!te sit&)ii.3&c> snt &7ect&te 8o&' o /&'te 8int'e &nse!e c&/i!&'e se +o'=e*te 8es/'e !e(ini se9ent&'e i&'c?n8 snt to&te &7ect&[email protected] 8es/'e !e(ini !o=&!e.1.3.4. -easor+ia tuular

    Este /'oces! /'in c&'e snt 'ec/e'&te &n9ite s=st&nte ti!e o'&nis9!i 8in !t'&7i!t'&t!!o9e'!&'@ 9entin&n85se &st7e! ho9ost&(i& !o' /!&s9&tic&. P'oces! este [email protected] in sens! c&se 'e&!i(e&(& 9&0i9&! /ent' 7iec&'e s=st&nt& int'5n se9ent t=!&' /'in &ctine& no'9ec&nis9e ce!!&'e s/[email protected] 7iin8 con8ition&t 8e 8e=it! s=st&ntei 'es/ecti+e si 8e necesit\ti!e

    o'&nis9!i. Re&=so'=ti& t'&ns/o't!D 8i7e'iti!o' constitenti 8in !t'&7i!t'&t /'in /e'ete!e t=!i'ini7e' se 7&ce /'in 9ec&nis9e &cti+e si /&si+e. T'&ns7e'! &cti+ se 'e&!i(e&(& cont'& no''&8iente 8e concent'&tie s& e!ect'[email protected] necesit&n8 n cons9 8e ene'ie 7'ni(&t& /'in hi8'o!i(&ATP. Mec&nis9e!e 8e t'&ns/o'[email protected] &cti+ & c&/&cit&te !i9it&t& /e nit&te& 8e ti9/ si inte'+in in'e&=so'=ti& !co([email protected] &n9ito' &9ino&ci([email protected] &ci8!i '[email protected] no' +it&9ine

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    e!i9in&'i!e in 7nctie 8e st&'e& 8e hi8'&t&'e & o'&nis9!i.Co9/o(iti& si +o!9! 7i!t'&t!i !o9e'!&' se 9o8i7ic& /'in t'ece'e& [email protected] !& ni+e!!

    t=!i conto't /'o0i9&[email protected] & &nsei en!e si t=!i conto't 8ist&!. o8i! este 'e&=so'=it !& 7iec&'e8int'e ce!e - se9ente &!e [email protected]/ot&si!este &=so'=it !& ni+e!! t=!i /'o0i9&! si sec'et&t !&ni+e!! t=!i 8ist&! in schi9=! so8i!iD. L& ni+e!! t=!i conto't /'o0i9&! se 'e&=so'=&ci(ii &9in&[email protected] !co(&@ c!o'! si 9&'e /&'te 8in =ic&'=on&ti.P'in inte'+enti& no' 9ec&nis9e 8e 'e!&'e se &si'& n echi!i=' int'e 7i!t'&'e& !o9e'!&'& si'e&=so'=ti& t=!&'& J=&!&nt& !o9e'!ot=!&'&[email protected] &9=e!e c'esc s& se 'e8c si9!t&n in 9!tesit&tii. Totsi 'e&=so'=ti& so8i!i se /o&te 9o8i7ic& in8e/en8ent 8e '&t& 7i!t'&'ii /'in inte'+enti&&!8oste'[email protected] /'in 9o8i7ic&'i 8e he9o8in&9ic& 'en&!& si /'in &ctine& /'ost&!&n8ine!o' si &

    /e/ti8e!o' n&t'i'etice &t'i&!e. in con8itii no'9&[email protected] /este $$ 8in so8i! 7i!t'&t este 'e&=so'=it.Ce& 9&i 9&'e c&ntit&te este &=so'=it& in t=! /'o0i9&! in 7nctie 8e st&'e& 8e hi8'&t&'e &o'&nis9!i. G!co(& se 'e&=so&'=e co9/!et !& ni+e!! t=i!o' in con8itii!e no' concent'&tii s&n+ine7i(io!oice. in =o!i &!e t=!i 'en&! /'o0i9&! este /e't'=&t& 'e&=so'=ti&@ sit&tie in c&'e este

    /'e(ent& !ico('i&.

    Re&=so'=ti& &ci(i!o' &9in&ti este J/'e7e'enti&!&J. Unii &ci(i &9in&ti esenti&!i se 'e&=so'=co9/!et in ti9/ ce &!tii se /ie'8 in 'in&. A9ino&ci8'i& 'en&!& este consecint& &D 7ie & no'8e7ecte s/eci7ice &!e 9ec&nis9e!o' en(i9&tice c&'e inte'+in in 'e&=so'=ti& &[email protected] =D 7ie /o&te'e/'e(ent& o co9/onent& & 8e7ect!i t=!&' !o=&!. Inte'/'et&'e& &9ino&ci8'iei &+e& in +e8e'eni+e!! se'ic 8eo&'ece c'este'e& concent'&tiei in s&ne se insoteste 8e e!i9in&'i 'in&'ec'escte.Fos7&tii snt 7i!t'&ti si 'e&=so'=iti /&'ti&! !& ni+e!! t=!i /'o0i9&!. Fos7&tii c&'e &Hn !& t=!8ist&! snt tit'&ti 8e c&t'e ^ sec'et&ti !& &cest ni+e!. Ace&st& 'e&ctie este n& 8int'e ce!e 9&i i9/o't&nte c&i 8e e!i9in&'e & ^.In con8itii 8e8iet&no'9&!&@ ce& 9&i 9&'e /&'te & =ic&'=on&t!i este 'e&=so'=it& in t=! /'o0i9&! i&' cee& ce'&9&ne se 'e&=so&'=e in t=! 8ist&[email protected] 'in& 7in&!& &n8 n / &ci8 si 7iin8 !i/sit& 8e =ic&'=on&t. incon8itii!e nei 8ietec &/o't c'esct 8e =ic&'=on&t e0. 8iet& e0c!si+ +eet&'i&n&D o c&ntit&te 8in

    =ic&'=on&t! 7i!t'&t n se 'eso&'[email protected] sit&tie in c&'e / 'in&' 8e/&seste . E0ist& s=st&[email protected] c9 &' 7i [email protected] /ent' c&'e n s5& /s in e+i8ent& o c&/&cit&te9&0i9& 8e 'e&=so'=tie t=!&'&. in schi9= /ent' !co(& si =ic&'=on&t s5& 8e9onst'&t oc&/&cit&te 9&0i9& 8e 'e&=so'=tie T9D i&' /ent' PA o c&/&cit&te 9&0i9& 8e sec'etie.ec'eti& 8e =&(e /te'nice si &ci(i /te'nici este co'e!&t& c /5! 'in&'. Acest 9ec&nis9 Ho&c&'o! i9/o't&nt in 'e!&'e& ho9eost&(iei &ci8o=&(ice. A9oni&c! =&(& /te'nic&D i& n&ste'e 8in!t&9in& !& ni+e!! ce!!e!o' t=!i 'en&! si 8i7(e&(& in !ichi8! t=!&' n8e se co9=in& chi8'oen ioniiIon! 8e &9oni &st7e! 7o'9&t n &'e c&/&cit&te 8e 'et'o8i7([email protected] '&9&n&n8 in !9en! t=!&'.A9oni! [email protected] /'in '9&'[email protected] n t&9/on i9/o't&nt /ent' hi8'oen ioni [email protected] i9/'en& c t&9/on!7os7&[email protected] cont'i=ie !& e0c'eti& nei c&ntit&ti i9/o't&nte 8e ^.

    1.3.5. Secre+ia tuularEste /'oces! in+e's ce!i 8e 'e&=so'[email protected] t'&ns/o't&n8 &n9ite s=st&nte 8in c&/i!&'e!e

    /e'it=!&'e in !9en! t=!i. A'e 'o!! 8e & e!i9in& &t&t s=st&nte!e st'&ine o'&[email protected] c&tsi s=st&nte!e /'e(ente o=isnit in s&ne _]@ &ci8 '[email protected] ne!e n9&i c&n8 se &7!& in concent'&tii9&'i c'e&tin&D. e 'e&!i(e&(& &cti+ si /&si+.

    ec'eti& &cti+&@ &+&n8 se8i! !& ni+e!! t=i!o' /'oni9&! si 8ist&[email protected] se 7&ce i9/ot'i+& no''&8iente e!ect'ochi9ice si 8e &cee& necesit& n cons9 ene'etic 'i8ic&t sec'eti& 8e ]D. P'ine!i9in&'e& ]t=ii 8etin n 'o! 7n8&9ent&! in 9entine'e& echi!i='!i &ci8o5=&(ic &!o'&nis9!i.

    ec'eti& /&si+& i9/!ic& t'&ns/o't! no' constitenti in sens! '&8iente!o' 8e concent'&tie si8e &cee& n necesit& cons9 ene'etic 8i'ect. Acest 9ec&nis9 inte'+ine in sec'eti& _]@ & =&(e!o'si & &ci(i!o' s!&=i.

    1

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    1.3.6.-e,larea ner)oase 'e&!i(e&(& /'in 7i='e!e +eet&ti+e c&'e se 8ist'i=ie &'te'io'e!o'@ !o9e'!!i si t=i!o'.

    iste9! +eet&ti+ n cont'i=ie 8i'ect !& cont'o!! e!&=o'&'ii '[email protected] ci 8o&' in8i'[email protected] /'inin7!ent&'e& con8itii!o' 8e i'i&tie 'en&!&. 3e &[email protected] se stie c& 'inichi! 8ene'+&t si chi&'t'&ns/!&nt&t contin& s& 7nctione(e &/'o&/e no'9&!. ti9!&'e& ne'+i!o' 'en&!i si & no' (one

    /'eso&'e 8in [email protected] hi/ot&!&9s si sco&'t& ce'e='&!& 8ete'9in& +&soconst'ictie 'en&!& si sc&8e'e&8i'e(ei /&n& !& &n'ie. ti9!&'e& ne'+i!o' +eet&ti+i 'en&!i /'o8ce si sc&8e'e& e!i9in&'i!o''in&'e 8e N&]@ /'in c'este'e& 'e&=so'=tiei t=!&'e & ion!i.1.3.. -e,larea umoral

    Consi8e'&t& & 8etine 'o!! /'inci/&[email protected] se 'e&!i(e&(& 8e 9&i 9!ti ho'9oni. o'9on!&nti8i'etin [email protected] sec'et&t 8e nc!eii hi/ot&!&9ici si e!i=e'&t 8in ne'ohi/o7i(&@ cont'o!e&(&e!i9in&'i!e 'in&'e 8e &/&@ &ction&n8 !& ni+e!! se9ent!i 8ist&! &! ne7'on!i. = &ctine&AN3 c'este 'e&=so'=ti& 8e &/& in t=ii 8ist&!i si co!ecto'[email protected] conco9itent c 8i9in&'e& +o!9!isi c'este'e& concent'&tiei 'inei.

    Mine'&!oco'ticoi([email protected] in s/eci&! &!8oste'[email protected] cont'o!e&(& e!i9in&'i!e 'in&'e 8e N&] si _]!& ni+e!! se9ent!i 8ist&! &! ne7'[email protected] sti9!&n8 'e&=so'=ti& 8e N&] si e0c'eti& 8e _].

    P&'&tho'9on! 9o=i!i(e&(& s&''i!e 9ine'&!e 8in o&[email protected] sti9!e&(& e!i9in&'i!e'en&!e 8e 7os7&[email protected] _] si 'etine C&] si N&]. o'9onii ti'oi8ieni intensi7ic& 9et&=o!is9! ce!!&'@in s/eci&! /e ce! /'oti8ic si /'in c'este'e& ene'&'ii 8e /'o8si 7in&!i 8e 9et&[email protected] 9&'esc8i'e(&@ &ce!&si e7ect &+&n8 si &!te'&'e& !e&'ii &/ei si & s&'ii in test'i.

    Rinichi! in con8itii 8e i'i&tie ins7icient& s& c& '9&'e & no' 9o8i7ic&'i &!eco9/o(itiei chi9ice & 'inei &Hns& in t=ii 8ist&[email protected] 8esc&'c& o en(i9&5'enin&5c&'e &ction&n8&s/'& nei !o=!ine /!&s9&[email protected] /'o8ce &niotensin& [email protected] c&'e se t'&ns7o'9& en(i9&tic in /!&s9&si test'i in &niotensin& [email protected] ce! 9&i /te'nic +&soconst'cto' n&t'&! si sti9!&to' &! sec'etiei 8e&!8oste'on. L& ni+e!! 'en&[email protected] &niotensin& [email protected] &ction&n8 &s/'& 9sc!&t'ii &'te'io'e!o'!o9e8!&'e 9o8i7ic& intens '&t& 7i!t'&'ii si /'in &!8oste'on in7!ente&(& e!i9in&'i!e 'in&'e 8e

    N&] si _].

    1.3.".!aracteristicile /i compo(i+ia uriniiC&'&cte'isticiP'i9! /'o8s =io!oic c&'e s5& &n&!i(&t in +e8e'e& /ne'ii ni 8i&nostic & 7ost 'in&. Inc&

    8e &c9 -,,, 8e &[email protected] 9e8icii 8in &nticht&te sti& s& e0&9ine(e 'in& si /e =&(& c&'&cte'e!o' s&!e7i(ice c&ntit&[email protected] c!o&'[email protected] !i9/e([email protected] s&[email protected] che&'[email protected] s/9&@ se8i9entD st&=i!e& 8i&nostic! sichi&' /'onostic! =o!i!o'.

    In e+! 9e8i & &/&'t 'osco/istii s& /'o'ocito'ii 8e 'in& c&'e /ne& 8i&nostic!tt'o' =o!i!o' n9&i /e =&(& e0&9en!i +i(&! &! 'inii. U'osco/istii &+e& si &Hto&'[email protected] Jc'ie'i8e 'in&J c&'e t'&ns/o't& 'in& 8e !& =o!n&+i in J!&=o'&to'!J 'osco/isti!o'. U'in& este /'o8s&8e 'inichi &t&t /'in 7i!t'&'e& s&ne!i 'in& /'i9&'&D c&t si /'in 'etine'e& 'e&=so'=ti&D 8in 'in&

    /'i9&'& n9&i & &ce!o' s=st&nte c&'e 9&i /ot 7i neces&'e co'/!i &/&@ (&h&'@ 9ine'&[email protected] etc.D.

    Cee& ce 9&i '&9&ne ne'etint 8in 'in& /'i9&'& o /&'te 8in &/& 9ine'&!&@ 'e(i8'i to0ice'e(!t&te 8in &'8e'e& &!i9ente!o'in o'&nis9D constitie 'in& 7in&!& c&'e se e!i9in& /'in c&i!e'in&'e. In 'in& se e!i9in& &st7e! /este 1", 8e s=st&nte [email protected] 9ine'&!esi o'&[email protected] 8&' in9o8 c'ent /ent' 8i&nostic! =o!i!o' se &n&!i(e&(& n9&i c&te+& co9/onete /'inci/&!e.

    Contint! 'iniiC!o&'e& 'inei no'9&!e este &!=ie s& 'osi&tic&. E& este 9&i inchis& !& c!o&'e c&n8 este

    7o&'te concent'&t& s& 8/& cons9! no' 9e8ic&9ente /i'&[email protected] &ntine+'&[email protected]'&cic!in&@&!=&st' 8e [email protected] etc.D. In =o!i!e insotite 8e e!i9in&'e& s&ne!i in 'in&@ 'in& &'e o c!o&'e'osie 9'8&'&. I&' in =o!i!e 8e 7ic&tc icte'@=i!&t'ec&n8 in s&ne se e!i9in& /'in 'in& /'o8c&n8o c!o&'e ='n&5ne'icio&s& c& =e'e& ne&'&D. i o se'ie 8e &!i9entec& s7ec!&@ +&'(& '[email protected]

    =o9=o&ne!e co!o'&[email protected] etc. /ot s& 9o8i7ice c!o&'e& no'9&!& & 'inei.Mi'os! 'inei este s/eci7ic. In in7ectii!e 'in&'e c&'e 8c !& 7e'9ent&'e& '[email protected] 9i'os!

    este c&'&cte'istic 8e &9oni&c s& 8e noi 8e '&H8. Une!e &!i9ente s& 9e8ic&9ente &'o9&te

    1#

    http://www.sfatulmedicului.ro/dictionar-medical/sediment-urinar_6466http://www.sfatulmedicului.ro/Diete-de-mentinere/alimente-pentru-o-dieta-sanatoasa_1562http://www.sfatulmedicului.ro/Vitamine-si-minerale/ingrediente-minerale_1468http://www.sfatulmedicului.ro/Vitamine-si-minerale/ingrediente-minerale_1468http://www.sfatulmedicului.ro/medicamente/tetraciclina-capsule_8541http://www.sfatulmedicului.ro/medicamente/tetraciclina-capsule_8541http://www.sfatulmedicului.ro/Ficatul-si-caile-biliare/ficatul_939http://www.sfatulmedicului.ro/dictionar-medical/bila_567http://www.sfatulmedicului.ro/Diete-de-mentinere/alimente-pentru-o-dieta-sanatoasa_1562http://www.sfatulmedicului.ro/Diete-de-mentinere/alimente-pentru-o-dieta-sanatoasa_1562http://www.sfatulmedicului.ro/dictionar-medical/sediment-urinar_6466http://www.sfatulmedicului.ro/Diete-de-mentinere/alimente-pentru-o-dieta-sanatoasa_1562http://www.sfatulmedicului.ro/Vitamine-si-minerale/ingrediente-minerale_1468http://www.sfatulmedicului.ro/medicamente/tetraciclina-capsule_8541http://www.sfatulmedicului.ro/Ficatul-si-caile-biliare/ficatul_939http://www.sfatulmedicului.ro/dictionar-medical/bila_567http://www.sfatulmedicului.ro/Diete-de-mentinere/alimente-pentru-o-dieta-sanatoasa_1562
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    c&'e se e!i9in& /'in 'in& /ot s&5i i9/'i9e &cestei& 9i'os'i &'o9&te. U'in& =o!n&+i!o' 8e8i&=et/o&te 9i'osi & &ceton&@ i&' & &!coo!ici!o' &&!coo!.

    T'&ns/&'ent& este c&'&cte'istic& 'inei /'o&s/ete 8/& c&te+& o'e 8e !& 'in&'e se /o&tet!='&@ 9&i &!es 8&c& este tint& !& 'ece. Acest !c' se 8&to'e&(& /'eci/it&'ii so!i8i7ic&'iiDs&''i!o' 9ine'&!e c&'e se &sesc in 9o8 no'9&! 8i(o!+&te in 'in& si n constitie si9/to9!+'enei =o!i &s& c9 c'e8 ne!e /e'so&ne. 3&' 8&c& 'in& /'o&s/&t&@ c&!8& este t!='e &tnci

    /o&te 7i +o'=& 8e o in7ectie /'oi si 9csD 8e o he9o'&ie s& 8e n cons9 7o&'te 9&'e 8e/'o8se =o&te in c&!ci!&/[email protected] ='&n(&D o'i 8e c&'ne.

    In c&(! nei 'ine c s&[email protected] /ot +e8e& /!tin8 che&'i c s&ne. Pent' & /te& &/'eci&8&c& 'in& este c!&'& s& t!='e t'e=ie s& 7ie e0&9in&t& int'5o stic!& s& e/'=et& neco!o'&t&.C&ntit&te& 8e 'in& in 24 8e o'e !& n &8!t +&'i&(& 8e !& [email protected]" !it'i. In se(on! c&[email protected] 8/& 7e='&@8/&+&'s&t'[email protected]&'[email protected] 8/& t'&ns/i'&tiiintense 8eshi8'&t&'[email protected] 8/& 79&ts& cons9 'e8s [email protected] c&ntit&te& 8e 'in& este 9&i 9ic&. In soc! /'o8s 8e he9o'&ii 9&'[email protected]&'s'is&t'&9&[email protected] in =o!i!e c&'e 'etin &/& in o'&nis9 ins7icient& c&'8i&c&@ ci'o(&he/&tic&Dc&ntit&te& 8e 'in& sc&8e 7o&'te 9!t. nt ne!e =o!i 8e 'inichi ins7icient& 'en&!&@in7ectii'en&!eD s& into0ic&tiic s=st&nte chi9ice in c&'e c&ntit&te& 8e 'in& sc&8e s= ",, 9!

    o!i'ieD. In &ceste sit&tii o'&nis9! s7e'& 8eo&'ece n se 9&i /ot e!i9in& /'in 'in& 8ese'i!enes&n&to&se 8in s&ne. In =o!i!e c&'e =!oche&(& c&i!e 'in&'e c&!c!i 'in&'[email protected] hi/e't'o7ie 8e/'ost&t&@ etc.D 8in c&(& 8i7ic!t&tii 8e & 'in&@ c&ntit&te& 8e 'in& este 9&i 9ic&. 3/& 7'[email protected]@ t'&t&9ente c 8i'[email protected] cons9 9&'e 8e [email protected] 8e &!i9ente s&'&[email protected] 8e &[email protected] c'este sic&ntit&te& 8e 'in& /este 2 !it'i /o!i'ieD.

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    A!=9in& 8in 'in& &!=9in'i&D A!=9in& s& /'oteine!e 'in&'e /'o+ine 8in &!=9in& s&nin&@ si in 9o8 no'9&! e& nse &seste in 'in&. 3&' in =o!i!e c&'e &!te'e&(& /o'ii 8in 7i!t'! 'inichi!o' s& in =o!i!e c&'e /'o8cs&ne'&'i /e t'&iect! c&i!o' 'in&'[email protected] &!=9in& t'ece in 'in& &!=9in'[email protected] /'otein'ieD. L& ne!e

    /e'so&ne c constittie 9&i s!&=& & 'inichi!o' 'in& /o&te contine &!=9in& in c&ntit&te 9&i 9ic&.Este +o'=& 9&i &!es 8e tine'i 8e 1"52" &[email protected] 8e o=icei s!&=i si in&[email protected] c&'e 8/& e7o't'i 7i([email protected] 8/&9e'[email protected] 8/& st&t! in8e!n&t in /icio&'e /'e(int& &!=9in'ie t'&n(ito'ie in ti9/! ([email protected] c&'e8is/&'e no&/te& si 8/& 'e/&s !& /&t. A!=9in'ii t'&n(ito'ii se 9&i int&!nesc 8/& 7'[email protected] st&'ie9otion&[email protected] +&ccin&'i si st&'i &!e'[email protected] 8/& cons9! 8e o&si 9e8ic&9ente in ti9/! s&'cinii.A!=9in'ii /e'9&nente si 9&si+e se int&!nesc 7'ec+ent in c&(! =o!i!o' 8e 'inichi si &!e c&i!o''in&'e =&([email protected] 'ete'[email protected] +e(ic&D !o9e'!one7'it&@ ne7'o(&@ cistit&@ /ie!ocistit&@ t=e'c!o(&'en&!&@ c&!c!i 'in&'i etc. i &!te =o!i c&'e /ot &tine 'inichi! se insotesc 8e &!=9in'ie c9snt hi/e'tensine&&'te'i&!&@ 8i&[email protected] =o!i!e 8e s&ne si 8e ini9&@ in7ectii c 9ic'o=is&+i's'[email protected] into0ic&tii c s=st&nte 9ine'&!e s& o'&nice.

    3eseo'i &!=9in'i& se insoteste 8e he9&t'ie. 3/& /ie'8e'e& c'onic& 8e &!=9in& /'in'in& se /'o8ce o sc&8e'e & /'oteine!o' co'/!i c consecinte ne&ti+e &s/'& int'e!i

    o'&nis9. In 9&'e& 9&Ho'it&te & c&('i!o' &!=9in'i& este 9o8e'&t& si se &/'eci&(& c&!it&[email protected] in'&/o't c c&ntit&te& 8e &!=9in&@ &st7e!5 &!=9in&`&=sent& no' 7o&'te 7in no' 7in si 8o(&=i!&.In &cest c&( se 7&ce si 8o(&'e& &!=9inei 8in 'in& c&'e se e0/'i9& in S!.A/'ecie'e& se 9&i /o&te 7&ce si /'in 15- /!s'i. Z&h&'! s& !co(& 8in 'in& !co('i& s&!ico('i&D Me8icii 8in &ntichit&te & o=se'+&t s& 'in& 8i&=etici!o' c&'e este [email protected] &t'&e& 7'nici!e si&!=ine!e si & n9it5o J'in& 8e &!=ineJ. Ei 7o!ose& &ceste insecte /ent' 8esco/e'i'e&8i&[email protected] 9eto8& &ce&st& 7iin8 ce& 9&i +eche J&n&!i(& 9e8ic&!&J c&'e se cno&ste. M&i t&'([email protected] s& &Hto&'e!e !o' /ne& '&/i8 8i&nostic! 8e 8i&=et (&h&'&tchi&' !& /&t! /&cient!i

    /'in si9/!& st&'e & 'inei. As& c9 s5& &'&t&t !& &n&!i(& (&h&'!i in s&[email protected] c&n8 !ice9i&8in

    8i&=et 8e/&seste 1",52,, 9S1,, 9! s&[email protected] !co(& (&h&'!D t'ece /'in 7i!t'! 'en&! si se e!i9in&/'in 'in&@ 8e n8e /o&te 7i &n&!i(&t&.3e 9ention&t c& !ico('i& n se int&!neste n9&i in 8i&=et ci si in &!te sit&[email protected] 8e

    e0e9/[email protected] 8/& n cons9 e0&e'&t 8e !co(& s& &!te (&h&''[email protected] 8/& 8i7e'ite 9e8ic&[email protected] !&7e9ei!e '&+i8esi !& /e'so&ne!e c&'e '9e&(& t'&t&9ente c ho'9oni. E0ist& /e'so&ne c&'[email protected] 7&'&s& &i=e 8i&=et (&h&'&[email protected] e!i9in& /e'9&nent s& /e'io8ic (&h&' /'in 'in& 8i&=et 'en&!D. Acest 7&/tse 8&to'e&(& ni 8e7ect &! 7i!t'!i 'en&! c&'e /e'9ite t'ece'e&!co(eiin 'in&@ c&'e nin7!ente&(& st&'e& 8e s&n&t&te & /e'so&nei 'es/ecti+e.1.3.#. 0ictiunea

    N9&'! 8e 9ictini 8e/in8e 8e c&ntit&te& 8e 'in& e9is& si 8e c&/&cit&te& 7i(io!oic& &+e(icii s=iect!i. Acest n9&' +&'i&(& 8e !& , !& 1 in ti9/! no/[email protected] 8e !& 4 !& " in ti9/! (i!ei.

    3'e'i!e !& 9ictine /ot 8e(+&!i o in7ectie 'in&'&si necesit& 8eci n e0&9en cito=&cte'io!oic&! 'inei.Mictine& se 'e&!i(e&(& s= 8e/en8ent&ni 9ec&nis9 ne'o!oic c&'e /o&te 7i cont'o!&t in 9o8+o!nt&'.3is'i& este o 8i7ic!t&te in & e+&c& +e(ic&. E& este consecti+& ni &8eno9 8e

    /'ost&t&@ nei inst&'i & 'et'ei s& nei cont'&ctii ins7iciente & 9schi!i +e(ic&!.5 En'e(i& este o e9isie 8e 'in&@ in+o!nt&'& si inconstient&@ in ene'&! noct'n&@ !& n co/i! c&'e& 8e/&sit +&'st& 8e/'in8e'ii c'&teniei int'e 2 si 4 &niD. E& /o&'te 7i c&(&t& 8e o i9&t'it&tene'o!oic& & +e(icii. Unii s/eci&!isti o &t'i=ie nei c&(e ho'9on&!e s& /sihoso9&tice.5 I9/e'io(it&te& 9iction&!& se t'&8ce /'int'5o inc&/&cit&te 8e & 'etine 'in&. E& 'e!e+& o i'it&tie &+e(icii.5 incontinent& 'in&'&/o&te 7i tot&!& s& /&'ti&!& 8e ce!e 9&i 9!te o'i s= 7o'9& neiincontinente'in&'e8e e7o'tD. E& este c&(&t& 8e o 8e7icient& &s7incte'!i 'et'ei.

    2,

    http://www.sfatulmedicului.ro/analize/albumina-serica_74http://www.sfatulmedicului.ro/Alimentatia-sanatoasa/tot-ce-trebuie-sa-stiti-despre-consumul-de-oua_3813http://www.sfatulmedicului.ro/Evolutia-sarcinii/sarcina-sunt-insarcinatai_1124http://www.sfatulmedicului.ro/Hipertensiunea-arteriala--HTA-/hipertensiunea-arteriala_148http://www.sfatulmedicului.ro/dictionar-medical/microb_1773http://www.sfatulmedicului.ro/Diabetul-Zaharat/diabetul-zaharat_894http://www.sfatulmedicului.ro/Analize-de-laborator/analize-biochimice-analiza-zaharului-din-sange-glicemia-si-din-urina-gli_1276http://www.sfatulmedicului.ro/dictionar-medical/sarcina-si-medicamentele_4407http://www.sfatulmedicului.ro/analize/glucoza-serica-sau-glicemie_62http://www.sfatulmedicului.ro/analize/glucoza-serica-sau-glicemie_62http://www.sfatulmedicului.ro/analize/glucoza-serica-sau-glicemie_62http://www.sfatulmedicului.ro/Infectii-urinare/prevenirea-infectiilor-urinare_590http://www.sfatulmedicului.ro/Analize-de-laborator/analiza-urinei-analiza-caracterelor-fizice-si-chimice-ale-urinei-analiza_1280http://www.sfatulmedicului.ro/Abuz--dependenta--si-intoxicatii/despre-dependenta_103http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.sfatulmedicului.ro/Incontinenta-urinara/incontinenta-urinara-exercitiile-kegel-stilul-de-viata-stresul-sarcina-g_586http://www.sfatulmedicului.ro/dictionar-medical/incontinenta_1185http://www.sfatulmedicului.ro/Infectii-urinare/infectiile-de-tract-urinar-la-femei-cistita-acuta-cronica-interstitiala-_589http://www.sfatulmedicului.ro/dictionar-medical/sfincter_2337http://www.sfatulmedicului.ro/Boli-genitale-masculine/afectiuni-ale-aparatului-genital-masculin_740http://www.sfatulmedicului.ro/analize/albumina-serica_74http://www.sfatulmedicului.ro/Alimentatia-sanatoasa/tot-ce-trebuie-sa-stiti-despre-consumul-de-oua_3813http://www.sfatulmedicului.ro/Evolutia-sarcinii/sarcina-sunt-insarcinatai_1124http://www.sfatulmedicului.ro/Hipertensiunea-arteriala--HTA-/hipertensiunea-arteriala_148http://www.sfatulmedicului.ro/dictionar-medical/microb_1773http://www.sfatulmedicului.ro/Diabetul-Zaharat/diabetul-zaharat_894http://www.sfatulmedicului.ro/Analize-de-laborator/analize-biochimice-analiza-zaharului-din-sange-glicemia-si-din-urina-gli_1276http://www.sfatulmedicului.ro/dictionar-medical/sarcina-si-medicamentele_4407http://www.sfatulmedicului.ro/analize/glucoza-serica-sau-glicemie_62http://www.sfatulmedicului.ro/Infectii-urinare/prevenirea-infectiilor-urinare_590http://www.sfatulmedicului.ro/Analize-de-laborator/analiza-urinei-analiza-caracterelor-fizice-si-chimice-ale-urinei-analiza_1280http://www.sfatulmedicului.ro/Abuz--dependenta--si-intoxicatii/despre-dependenta_103http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.sfatulmedicului.ro/Incontinenta-urinara/incontinenta-urinara-exercitiile-kegel-stilul-de-viata-stresul-sarcina-g_586http://www.sfatulmedicului.ro/dictionar-medical/incontinenta_1185http://www.sfatulmedicului.ro/Infectii-urinare/infectiile-de-tract-urinar-la-femei-cistita-acuta-cronica-interstitiala-_589http://www.sfatulmedicului.ro/dictionar-medical/sfincter_2337http://www.sfatulmedicului.ro/Boli-genitale-masculine/afectiuni-ale-aparatului-genital-masculin_740
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    5/o!&i'i&se c&'&cte'i(e&(& /'in 9ictini7'[email protected] s'+enin8 (i& s& no&/te&. E& t'&8ce oi'it&tie & +e(icii&8eno9 8e /'ost&t&@ cistit&@ c&!c! &! +e(iciiD s& o 8i9in&'e & c&/&cit&tii s&!e

    Mictine& este 'e(!t&t! no' 'e7!e0e 8ec!&ns&te 8e 8istensi& /e'eti!o' +e(ic&!i.I9/!s'i!e &7e'ente snt t'&ns9ise ni cent' !o9=&' si9/&[email protected] 8e n8e se 8esc&'c& i9/!s'i&7e'ente c&'[email protected] /'in 7i='e!e hi/o&st'[email protected] inhi=& cont'&[email protected] 'e!&0e&(& 9schii +e(ic&!i si int&'esctons! s7incte'!i nete8 &! co!!i +e(ic&!.

    Conco9itent 8istensi& +e(ic&!& 8ec!&nse&(& i9/!s'i c&'e &Hnse !& 9&8+& /e c&!e&ne'+i!o' 'sinosi snt con8se &/oi /e c&i &7e'ente nes/eci7ice s/'e cent'ii ne'+osi s/e'io'[email protected]&Hn&n8 /&n& !& ni+e!! sco&'tei ce'e='&[email protected] 8ete'9in&n8 sen(&ti& 8e & 'in&.

    3&c& 9ictine& n este /osi=i!&@ i9/!s'i!e /o'nite 8e !& co'[email protected] /'in cent'ii 9e8!&'[email protected]=\ tons! 9schi!i +e([email protected] conco9itent 9&'esc tons! s7incte'!i e0te'[email protected] 9&'in8continent& +e(ic&!&. 3&c& con8itii!e /e'[email protected] &'e !oc 9ictine&.

    3is'i& 'e/'e(int& 9ictine& c e7o't si n inse&9n& 8'e'e !& 9ictine.In 9o8 no'9&[email protected] &ct! 9iction&! n /'es/ne e7o'[email protected] 8is'i& 'e/'e(ent&n8 &/&'iti& necesit&t&tiic'este'ii +o!nt&'e & /'esinii &=8o9in&!e /'in cont'&cti& /'esei &=8o9in&!e.3is'i& se /o&te 9&ni7est& o=iecti+ /'in sc&8e'e& /'esinii Het!i 'in&' s& int'e'/e'e&

    &cesti&@ 8&to'it& /'e(entei ni o=st&co! !& o!i'e&+e(icii 'in&'e.Mictine& 8'e'o&s& c&'&cte'i(e&(& in7!&9&tii!e +e(ic&!e s& &!e 'et'ei. 3'e'e& &'e 8e ce!e 9&i9!te o'i c&'&cte' 8e st'i9e. 3'e'e& se /o&te int&!ni /e tot /&'c's! s& n9&i !& s7&'sit!9ictinii.

    Po!&chi'i& 'e/'e(int& o c'este'e & n9&'!i 8e 9ictini c 'e8ce'e& /'o/o'tion&!& &c&ntit&tii 8e 'in& c&'e este e!i9in&t& in ti9/! ni &ct 9iction&!. Po!&i'i& este 8esc'is& 8ec&t'e /&cient c& 'in&t /tin si 8es. Po!&i'i& n este insotit& 8e 8is'ie &8ic& 8e e7o't !&[email protected] 8'e'e s& &!t& 9o8i7ic&'e & 8i'e(ei

    21

    http://www.sfatulmedicului.ro/dictionar-medical/polachiurie_5449http://www.sfatulmedicului.ro/dictionar-medical/mictiune_1777http://www.sfatulmedicului.ro/dictionar-medical/cancer-vezical_628http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.terapiamedicala.ro/vezica-urinara-anatomiehttp://www.terapiamedicala.ro/vezica-urinara-anatomiehttp://www.sfatulmedicului.ro/dictionar-medical/polachiurie_5449http://www.sfatulmedicului.ro/dictionar-medical/mictiune_1777http://www.sfatulmedicului.ro/dictionar-medical/cancer-vezical_628http://www.sfatulmedicului.ro/Afectiunile-prostatei/adenomul-de-prostata_609http://www.terapiamedicala.ro/vezica-urinara-anatomie
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    CAPITOLUL 2 NOIUNI DESPRE-COLIC RENAL

    2..D$9)%),)$Co!ic& 'en&!& este o 8'e'e 7o&'te /te'nic&@ ='sc&@ s7&sieto&'[email protected] c&'e &'e o'iine& 8o's&! !&ni+e!! s/&[email protected] in (on& 8e /'oiectie & 'inichi!i 9&i Hos 8e !ti9& co&st&D. 3'e'e& i'&8i&(&s/'e &nte'io'@ s/'e ='t&@ s/'e 7&t& inte'n& & /icio'!i si o'&ne!!e enit&!e e0te'ne /[email protected] sc'[email protected]+!+&D. 3'e'e& n este contin&@ &'e o e+o!tie on8!&nt& 9o9ente 8'e'o&se '9&te 8e&c&!9ie. M&0i9! 8e intensit&te &! 8'e'ii este /e t'&iect! !ti9ei co&[email protected] !& ni+e!! co!o&nei si

    /&n& !& o /&!9& !&te'&! e&.C&(e!e co!icii 'en&!e

    a C&!c!i 'en&!i /iet'e !& 'inichiDa Che&'i 8e s&nea F'&9ente t9o'&!e

    a C&(e9 in t=e'c!o(& 'en&!&D5 9&s& 8e s=st&nt& nec'o(&t& =o&t& in /'oteine si !i/[email protected]&se9&n&to&'e c ='&n(&a Nec'o(& /&/i!&'&a T'&9&tis9e

    2.2 C'/1$C9 se 9&ni7est&b

    Ce! 9&i 7'[email protected] co!ic& 'en&!& este 8ete'9in&t& 8e /'e(ent& c&!c!i!o' 'en&!i. At&t ti9/c&t c&!c!ii snt [email protected] /&cient! '&9&ne &si9/to9&tic s& /'e(int& oc&(ion&! 8'e'i !o9=&'enes/eci7ice. C&n8 se 9o=i!i(e&(& n c&!c! 'en&! si i'it& 'ete'! &/&'e co!ic& 'en&!& c 8'e'i

    co!ic&ti+e /'o'esi+e in 'eine& !o9=&'& s& 7!&nc'i. 3'e'e& /o&te i'&8i& s/'e o'&ne!eenit&!e e0te'ne si 7&t& inte'io&'& & co&/sei 5 in c&!c!i 'ete'&!i /'o7n8 inse'&ti. 3e &se9ene&@8'e'e& /o&te &/&'e& in '9& no' t'e/i8&[email protected] inestii 8e !ichi8e in c&ntit&te 9&'[email protected] & t'&t&9ent!i8i'etic s& 7&'& o c&(& &/&'ent&. 3'&t& +&'i&(& 8e !& c&te+& 9inte !& c&te+& o'e si se /o&te'e/et& 8&c& n se in!&t'& c&(&.

    3e=t! co!icii este /'e8i!ect no&/te& /'int'5n &cces 8'e'os [email protected] c& o !o+it'& 8e/9n&! =o!n&+! se t&+&!este /e Hos 8e 8'e'[email protected] &tine n /&'o0is9 si &/oi !ent 8is/&'e c s&7&'& t'&t&9ent

    3'e'e& c c&'&cte' 8e !o+it'& 8e /9n&! i'&8i&(& /e t'&iect! 'ete'!i s/'e te'ito'i!enitoc''&!. In co!ic& testic!! este &8ese& 'et'&ct&t s/'e ine!! inhin&! /'in cont'&cti&c'e9&ste'!i si /o&te /'e(ent& o sensi=i!it&te 8eose=it&.Co!ic& 'en&!&@ c&'e neo'i /o&te i9='&c&

    &s/ect! nei co!ici s=int'&nte co!ici 'e/et&teD se insoteste 8e 'e!& 8e 7eno9ene 'in&'et!='&'i 8e 9ictine 5 /o!&i'[email protected] 8is'[email protected] tenes9e +e(ic&!e si he9&t'ieD.

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    E& ce8e&(& in tot&!it&te !& 9e8ic&ti& &ntis/&stic& s& o8&t& c e!i9in&'e& c&!c!i.C&(e!e co!icii 'en&!eLiti&(& 'en&!& 5 #,5$, 8in c&('i!e 8e !iti&(& 'en&!& e+o!e&(& c co!ic&T=c 'en&! he9&t'ie c 9i'&'e 8e che&'i 'en&!eDC&nce'! 'en&! 5 e!i9in&'e& 8e test nec'o(&tIn7&'ct! 'en&!i8'one7'o(& si 9&!7o'9&tii conenit&!e /'in 8istensi& =&(inet!iLece9i& 9ie!oi8& in c&( 8e '&8iote'&/ieT'&t&9ent! neH8icios c s!7&9i8e ce 8ete'9in& c&!c!i s!7&9i8ici

    e9ne +e(ic&!e5 e9&t'i& /'e(ent& 8e s&ne in 'in&D in /este , 8in c&('i5 3is'ie 8'e'e !& 'in&'eD5 Po!&i'ie /&cient! 'ine&(& 8esD5 Tenes9e +e(ic&!e sen(&ti& 8e 'in&'e inco9/!et&D.

    e9ne!e ene'&!e snt5

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    e9&t'i& 9ic'osco/ic& este 8esco/e'it& in 9o8 &cci8ent&[email protected] in ti9/! ni test 8e 'in& ce7&ce /&'te 8int'5o e0&9in&'e 9e8ic&!& 8e 'tin&. In [email protected] he9&t'i& 9&c'osco/ic& 8ete'9in& inene'&! /'e(ent&'e& 'ent& !& 9e8ic. e9&t'i& /o&te &+e& 8'e/t se8i o'ice co9/onent& &t'&ct!i 'in&' '[email protected] 'ete'[email protected] +e(ic& 'in&'&@ /'ost&t& s& 'et'&. e esti9e&(& c& int'e [email protected]" si21 8in /o/!&tie s7e'& 8e he9&t'ie.L& n9e'osi /&[email protected] c&(& &7ectinii n este i8enti7ic&t& c to&te &ceste&@ he9&t'i& este nse9n 8e &!&'9& /ent' [email protected] c&!c!i 'en&[email protected]& c&nce'.

    2.;. C58'e'e&. :n co!ic& 'en&!> ti/ic>@ &ce&st& &'e se8i !o9=&'@ este inte'9itent>@ co!ic&ti+>[email protected] i'&8i&(>n 7!&nc! *i 7os& i!i&c> ho9o!&te'&!>@ /e t'&iect! &/'o0i9&ti+ &! 'ete'[email protected] s/'e +e(ic> *io'&ne!e enit&!e e0te'[email protected] se nso)e*te 8e 7eno9ene 'in&'e /o!&chi'[email protected] &!'[email protected] tenes9e+e(ic&!>@ he9&t'[email protected] ce! /)in 9ic'osco/ic>D *i 7eno9ene +eet&ti+e 8e ti/ +&&! 'e&)>@ +o9>@

    /&!o&'e. @ &/'o&/e /&tono9onic>@ c>t?n8 o /o(i)ie&nt&!ic> c&'e n e0ist>. E0&9en! [email protected] 8i7ici! 8e 'e&!i(&t n /!in> co!ic>@ /o&te 'e!e+& one7'o9e&!ie 8'e'o&s> s& sensi=i!it&te& /ncte!o' 'ete'&!e.

    24

    http://www.romedic.ro/litiaza-renalahttp://www.romedic.ro/litiaza-renalahttp://www.bendo.ro/cauzele-formarii-litiazei-urinare/http://www.romedic.ro/litiaza-renalahttp://www.bendo.ro/cauzele-formarii-litiazei-urinare/
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    2.>. D)'6%5*)Pent' ce'tit8ine si /ent' '9&'i'e& =o!n&+!i se +& 7&ce

    1. eco'&7ie c&'e +& e+i8enti& se8i! *i n&t'& o=st&co!!i2. '&8io'&7ie 5 /e'9ite +i(&!i(&'e& c&!c!i-. s9&'! 8e 'in& 5 &'&t& /'e(ent& s&[email protected] & 9ic'o=i!o' si & !ecocite!o' se9n 8e in7ectie'in&'&D si e!i9in&'e& 8e nisi/ 7in c'ist&!'ieD.C&!c!ii 8e c&ti+& 9i!i9et'i se e!i9in& so'. Cei c&'e & ci'c& 1 c9 se /ot e!i9in&@ 8&' 9&i 'e.Cei c&'e & 9&i 9!t 8e 1 c9 t'e=ie tinti s= o=se'+&tie.

    3i&nostic! 8e co!ic& 'en&!& n este n! si9/!. nt 9!te =o!i c&'e /ot 9i9& o co!ic&'en&!& co!ic> =i!i&'>@ &/en8icit>@ c'i(& 8e !ce'@ /&nc'e&tit&.

    3i&nostic /o(iti+8'e'e !o9=&'& +io!ent&@ 8e=t ='[email protected] e0&ce'=&'i ce 8ete'9in& o st&'e 8e&it&tie & =o!n&+!ii'&8ie'e& 7!&[email protected] hi/o&st'@ o' enit&!e s& 'eine& inhin&!&&7e='i!&@&/&'iti& 7e='ei inse&9n& 'etentie se/tic& in c&i!e 'in&'e in&!tee0&ce'=&te !& /&!/&'e si /e'cti&'einii !o9=&'e /&!/&'e& he9i&=8o9en!i /o&te 7i 8'e'o&s&9&ni7est&'