Chronic Kidney Injury Flashcards
What time frame of deteriorating kidney function fits the definition of chronic kidney disease?
> 3 months
List 12 causes of CKD:
1) polycystic kidney disease
2) medullary cystic disease
3) tuberous sclerosis
4) oxalosis
5) cystinosis
6) congenital obstructive uropathy
7) glomerulonephritis
8) hypertensive nephrosclerosis
9) tubulointerstitial disease
10) urinary tract obstruction
11) diabetic nephropathy
12) chronic pyelonephritis
Which type of polycystic kidney disease is more common?
Autosomal dominant (adult)
What is medullary cystic disease?
An autosomal dominant disorder characterised by tubulointerstitial sclerosis, leading to end-stage renal disease
What is tuberous sclerosis?
a rare, multisystem autosomal dominant genetic disease that causes benign tumours to grow in the kidneys, brain, heart, liver and lungs
What is oxalosis?
a hereditary or secondary condition where there is supersaturation of calcium oxalate in urine which results in kidney stones and cortical nephrocalcinosis
What is cystinosis?
an autosomal recessive disorder and lysosome storage disease characterised by the abnormal accumulation of cystine leading to crystal formation in the kidneys
What is Fanconi syndrome?
A defect in proximal tubule reabsorption so almost all of the filtrate is excreted (large loss of fluid, potassium, phosphate, and abnormal levels of carbohydrates and amino acids in urine)
What is the most common cause of Fanconi syndrome?
Cystinosis
What is glomerulonephritis?
inflammation and damage to glomeruli, allowing protein and sometimes blood to leak into the urine
Give 8 types of glomerulonephritis:
1) minimal change disease
2) focal segmental glomerulosclerosis
3) membranous glomerulonephritis
4) IgA nephropathy/ Berger’s disease
5) Post-infectious glomerulonephritis
6) membranoproliferative glomerulonephritis
7) Granulomatosis with polyangiitis
8) Microscopic polyangiitis
Does minimal change disease cause nephrotic or nephritic syndrome?
nephrotic
What would you find on light microscopy of a glomerulus affected by minimal change disease?
nothing (hence minimal change)
Does focal segmental glomerulosclerosis cause nephrotic or nephritic syndrome?
nephrotic
What is focal segmental glomerulosclerosis?
sclerosis affecting some but not all glomeruli and involving only segments of each
What is membranous glomerulonephritis?
deposition of immune complexes resulting in complement activation against the glomerular basement proteins, causing thickening
Does membranous glomerulonephritis result in nephrotic or nephritic syndrome?
nephrotic
What is nephrotic syndrome?
A condition results from excreting too much protein in urine due to a kidney disorder. This causes swelling in ankles, feet and around eyes, foamy urine, obesity, and fatigue.
The definition of nephrotic syndrome includes both massive proteinuria (≥3.5 g/day) and hypoalbuminaemia (serum albumin ≤30 g/L). 1
What is nephritic syndrome?
Nephritic syndrome is a condition involving haematuria, mild to moderate proteinuria (typically less than 3.5g/L/day), hypertension, oliguria and red cell casts in the urine.
What are 3 conditions associated with membranous syndrome?
- Hepatitis B
- SLE
- Malaria
What is the most common form of glomerulonephritis in adults, worldwide?
IgA nephropathy/ Berger’s disease
does IgA nephropathy (Berger disease)present as nephritic or nephrotic syndrome?
Nephritic
What is IgA nephropathy?
IgA immune complex deposition in mesangium tissue of glomeruli, causing scarring and increased matrix production
What is post-infectious glomerulonephritis?
an immunologically mediated glomerular injury triggered by an infection
What group of bacteria typically causes post-infectious glomerulonephritis?
Streptococci
How long after a Streptococci infection does post-infectious glomerulonephritis present?
2 weeks
What is membranoproliferative glomerulonephritis?
a group of immune-mediated disorders characterised histologically by glomerular basement membrane thickening including the mesangium tissue
What two diseases are associated with membranoproliferative glomerulonephritis?
- Hep C
- SLE
What is mesangium?
interstitial tissue located between glomerular capillaries
What is the difference between membranous glomerulonephritis and membranoproliferative glomerulonephritis?
white both result in thickening of the basement membrane, only membranoproliferative glomerulonephritis results in thickening of the mesangium
Does membranoproliferative glomerulonephritis present with nephrotic or nephritic syndrome?
nephritic