Class #4 Flashcards
How do the kidneys maintain bone calcium levels?
By Activating vitamin D
What is Glomerulonephritis?
2nd leading cause of kidney failure
What causes Glomerulonephritis?
-Hereditary
-Other disease process
-Injury from antibodies reacting with antigens in the glomeruli
injury from circulating antibody/antigen complexes that lodge in the glomeruli
What are the 4 types of glomerularnephritis?
Proliferative Infiltration of WBCs and proliferation of glomerular cells Membranous Thickening of glomerular capillary wall Sclerotic Increased extracellular matrix Diffuse/focal/segmental Ex: Mesangial (involves only these cells)
Manifestations of Acute Nephritic Syndrome
Hematuria** HALLMARK SIGN Decreased GFR Azotemia (build up of nitrogenous waste) Oliguria Fluid retention (edema, HTN) *Shortness of Breath from the buildup of fluid*
What is Acute Nephritic Syndrome?
Inflammatory response that damages the glomerular capillary wall
How can nephritic syndrome be treated?
- children have spontaneous recovery
- Adults–treat the symptoms
- antibiotics
- fluids
What is rapidly progressive glomerulonephritis? Explain the patho.
signs of severe glomerular injury without a specific cause.
*Proliferation of glomerular cells, with monocytes & macrophages destroy Bowman space
Name a rare type of rapidly progressive glomerulonephritis
Goodpastures Syndrome
What is Nephrotic Syndrome?
Damage to the integrity of the glomerular membrane caused by medications, neoplasms, inflammation
Symptoms of Nephrotic Syndrome?
- Increased GFR, but you are losing things into your urine that you shouldnt
- Massive proteinuria
- Hypoalbuminemia
- Edema (anasarca) : When you lose the protein in your urine, the blood doesn’t have the osmotic pressure to hold fluid in your vascular space
- Lipiduria–Lose lipids in your urine
- Hyperlipidemia–compensatory action when you lose proteins and lipids and your liver synthesis more proteins to increase lipids
What is acute pyelonephritis? What causes it?
Caused by Bacterial infection of upper UT with infrarenal reflux, or movement of urine in the wrong direction
TRUE OR FALSE
Nephritic syndromes are characterized by blood in the urine?
TRUE
What are contributing factors to acute pyelonephritis?
Outflow obstruction Catheterization Vesicoureteral reflux (urine moves backwards from the ureters into the bladder and into the kidney) Pregnancy -Neurogenic Bladder
Manifestations of acute pyelonephritis
Rapid chills and fever Ache/pain unilateral or bilateral *Costovertebral Angle -Dysuria, frequency, urgency -N/V, abdominal pain radiating to the back
Treatment of acute pyelonephritis
Symptomatic pain relief
Fluids to aid dysuria
Antibiotics
Chronic pyelonephritis. What does it usually affect?
Scarring and deformation of renal calyces and pelvis, with atrophy and thinning of cortex
Usually affects the proximal and distal tubules
What causes chronic pyelonephritis?
- Recurrent or persistent infection
- Intrarenal reflux
What does the effect of toxin-related nephropathies dependent on?
- Action of drugs/toxins
- Number of toxins involved
- Existence of pre-renal issues that decrease blood flow to kidney
- Formation of crystals
- Hypersensitivity response
What is polycyctic Kidney Disease?
Inherited autosomal dominant
Generally older population; progresses slowly
Fluid-filled cysts in kidney and liver
Deformity of epithelial cell interfere with fluid absorption/cellular maturation resulting in cyst formation
-Inflammatory mediators accumullate, and renal tubular cells are destroyed
Kidneys are enlarged
Manifestations of PKD
Pain
Hematuria
Infected cysts—UTI
HTN
Complications of PKD
- Nephrolithiasis (REALLY COMMON! kidney stones)
- Valvular deformities (inflammation, bacterial involvment)
- Cerebral artery aneurysm
What can obstruct flow in the ureters?
Calculi, pregnancy, tumors, stricture, congenital origins
obstructions in the bladder & the ureter
Calculi, neurogenic bladder, cancer, Benign prostatic hypertrophy, strictures
