Chapter 33 Disorders of Renal Function Flashcards
What are the most common fetal renal anomalies?
anomalies in the shape and position of the kidneys, decrease in size, or change in renal structure
What causes a person to develop a horseshoe kidney
dysgenesis - failure of the organs to develop normally
What are the examples of renal anomalies that involve decrease in size or kidney structure
agenisis which is failure of an organ to develop, and hypoplasia which is failure of an organ to reach the normal size so it is smaller than normal
What is an example of renal fetal anomaly involving a change in renal structure
renal cysts
what is the most common cystic disease of the kidney?
autosomal dominant polycystic kidney disease
what are the manifestations of autosomal dominant polycystic kidney disease
high BP, blood in the urine, increased size of the belly from enlarged kidneys, headaches, kidney stones, kidney stones, kidney failure, UTI, kidney infections
what is the average age of onset for autosomal dominant polycystic kidney disease
manifests after 40 years
What is the treatment for autosomal dominant polycystic kidney disease?
dialysis or kidney transplant
what is the cause for autosomal dominant polycystic kidney disease
mutations in the connective tissue that causes cysts to form
What causes cysts on the kidney
tubular obstructions that increase intratubular pressure, changes in the membrane of renal tubules that predispose it to cysts
What causes urinary tract obstructions?
developmental defects, calculi (stones), pregnancy, Benign prostatic hyperplasia, scar tissue (generally from repeat UTIs), spinal cord injuries
How can you treat a urinary tract obstruction
stents in the urethra to promote flow of urine
What is urine stasis and what does it cause?
when urine sits and isn’t expelled, it predisposes for infection and stone formation
what are manifestions of urinary obstructions?
pain, signs and symptoms of UTIs, renal dysfunction, limited urine production
What is an example of urinary obstruction?
hydronephrosis
what is hydronephrosis?
obstruction causes dilation of renal pelvis and causes atrophy of the kidney – the kidney gets blocked and then the tissue starts to die - diagnosed with diagnostic imaging
What are the 3 types of kidney stones and which is more common?
- Calcium oxalate and calcium phosphate make up 70-80% of stones
- struvite (magnesium, ammonium, phosphate) make up 15% of stones
- Uric Acid makes up 7% of kidney stones
What is the most common cause of a urinary tract obstruction?
kidney stones
What are things that a person does that can predispose them to developing kidney stones?
eating foods high in oxalic acid like Brussel sprouts, and broccoli, and then also drinking well water that is generally higher in calcium than filtered water
What are the clinical manifestations of kidney stones?
renal pain
How do you diagnose kidney stones?
urinalysis, diagnostic imaging
What is the treatment for kidney stones?
pain relief, promotion of the passage of the stone (drink lots of water), alteration in urine pH (drinking cranberry juice or light beer), and removal of the stones using percutaneous nephrolithotomy, ureteroscopy, extracorporeal lithotripsy with the goal of breaking the stone into smaller pieces that would be able to pass easier.
What is glomerulonephritis?
inflammation of the glomeruli
What causes glomerulonephritis?
cross reacting antibodies or circulating antigen-antibody complexes that get stuck in the glomeruli
What can glomerulonephritis cause?
basement membrane thickening, sclerosis, fibrosis which can damage the filtration membrane, RBCs can escape into the urine, decrease in GFR which means the kidneys are not functioning as well
What is the function of the glomerulus?
filter plasma and produce glomerular filtrate which then goes on to form urine
What is a common sickness whose antibody complexes can get stuck in the kidneys and cause glomerulonephritis?
strep throat
what are the clinical manifestations of glomerulonephritis?
proteinuria (protein in the urine), hematuria, low GFR, Azotemia (nitrogenous wastes in the blood), oliguria, hypertension and edema
What is an example of glomerular diseases?
nephrotic syndrome
What is nephrotic syndrome?
glomerular disease where there is damage to the clusters of small blood vessels in the kidneys that filter wastes and water from the blood, causes the body to pass too much protein in your urine
What are clinical manifestations of nephrotic syndrome?
swelling in feet and ankles, hypoalbuminemia, lipiduria, dyspnea, susceptibility to infection
What can cause nephrotic syndrome?
diabetes, hypertension, anything that can damage the capillaries
Why can diabetes cause nephrotic syndrome
because diabetes and the fluctuations in blood sugar can damage the lining of blood vessels leading to damage.
What is acute pyelonephritis?
acute infection of the ureter, renal pelvis, renal parenchyma (functional tissue of the kidney)
What causes acute pyelonephritis?
UTIs
What are the clinical manifestations of acute pyelonephritis?
flank pain, fever, chills, costovertebral tenderness, dysuria, pyuria (WBCs in the urine), white blood cell casts
How do you treat acute pyelonephritis?
antibiotics
What is chronic pyelonephritis?
recurrent infection of the kidneys that leads to scarring, inflammation and fibrosis which can lead to chronic kidney failure
How would you treat chronic pyelonephritis?
antibiotics, prolonged antibiotics
What are renal neoplasms?
renal tumors
What are examples of renal neoplasms?
Wilms Tumor, adult kidney cancers
What is Wilms tumor?
renal neoplasm that is an inherited embryonic kidney tumor, you might not necessarily be born with the tumor but as the kidney grows then the mutations also grow and divide and can cause tumors
What is the onset age for Wilms tumors?
2-5 years old
What is an example of an adult kidney cancer?
renal carcinoma
What is renal carcinoma?
renal cancer
What is the treatment for renal neoplasms?
radiation, chemo and/or surgery for removal of the tumor
