6.2 RENAL DISEASES - TUBULAR Flashcards
What disorders are classified under acute tubular necrosis (ATN)?
Ischemic ATN and Nephrotoxic ATN
What disorder involves tubular damage caused by reduced blood flow and oxygenation?
Ischemic ATN
What disorder involves tubular damage due to exposure to toxic substances?
Nephrotoxic ATN
What disorders are classified under hereditary and metabolic tubular disorders?
Fanconi Syndrome,
Alport Syndrome,
Uromodulin-Associated Kidney Disease,
Diabetic Nephropathy,
Nephrogenic Diabetes Insipidus, and
Renal Glycosuria
What disorder is associated with generalized failure of proximal tubular reabsorption?
Fanconi Syndrome
What disorder results from defective collagen production affecting the glomerular basement membrane?
Alport Syndrome
What inherited disorder involves abnormal uromodulin accumulation in tubular cells?
Uromodulin-Associated Kidney Disease
What is the leading cause of ESRD, characterized by glomerular damage due to poorly controlled blood glucose?
Diabetic Nephropathy
What disorder is caused by the inability of renal tubules to respond to ADH?
Nephrogenic Diabetes Insipidus
What disorder is characterized by failure of glucose reabsorption in the renal tubules?
Renal Glycosuria
Name three conditions that can cause ischemic ATN.
Shock, trauma, and surgical procedures
What are examples of nephrotoxic substances that can cause ATN?
Aminoglycosides,
amphotericin B,
cyclosporine,
radiographic dye,
ethylene glycol,
heavy metals,
toxic mushrooms
What urinalysis findings are characteristic of ATN?
Mild proteinuria,
microscopic hematuria,
RTE cells,
RTE cell casts, and
other casts (hyaline, granular, waxy, broad)
What is the most specific finding in the sediment of patients with ATN?
RTE cell casts and RTE cells
What tubular function is disrupted in Fanconi syndrome?
Generalized failure of proximal tubular reabsorption
What substances are affected by Fanconi syndrome?
Glucose,
amino acids,
phosphorus,
sodium,
potassium,
bicarbonate, and
water
What are possible causes of Fanconi syndrome?
Inherited disorders (e.g., cystinosis, Hartnup disease),
toxic agents (e.g., heavy metals, outdated tetracycline),
multiple myeloma,
renal transplant
What urinalysis findings are associated with Fanconi syndrome?
Glycosuria with normal blood glucose,
mild proteinuria,
very low urinary pH
What genetic defect causes Alport syndrome?
Defective collagen production affecting the glomerular basement membrane
How is Alport syndrome inherited?
X-linked or autosomal
What are common symptoms of Alport syndrome in males younger than 6 years?
Macroscopic hematuria during respiratory infections, progressing to microscopic hematuria
What systemic abnormalities are associated with Alport syndrome?
Hearing and vision abnormalities
What is the prognosis for Alport syndrome?
Ranges from mild symptoms to ESRD
What protein is defective in uromodulin-associated kidney disease?
Uromodulin
How is uromodulin-associated kidney disease inherited?
Autosomal dominant mutation
What complication precedes renal disease in uromodulin-associated kidney disease?
Gout due to increased serum uric acid
What is the ultimate outcome of uromodulin-associated kidney disease?
Renal transplantation
What is the leading cause of ESRD?
Diabetic nephropathy
What structural changes occur in diabetic nephropathy?
Glomerular basement membrane thickening,
mesangial cell proliferation,
sclerosis of the vascular structure
What early laboratory marker is used to detect diabetic nephropathy?
Microalbuminuria
How can the progression of diabetic nephropathy be slowed?
Diet modification and strict hypertension control
What causes nephrogenic diabetes insipidus (DI)?
Inability of renal tubules to respond to ADH
What are common causes of nephrogenic DI?
Sex-linked inheritance,
medications (e.g., lithium, amphotericin B),
complications of polycystic kidney disease or sickle cell anemia
What urinalysis findings are associated with nephrogenic DI?
Low specific gravity, pale yellow color, possible false-negative chemical tests
What is the defect in renal glycosuria?
Failure to reabsorb glucose in the tubules
How is renal glycosuria inherited?
Autosomal recessive
What laboratory finding is indicative of renal glycosuria?
Increased urine glucose with normal blood glucose
