Diabetic Nephropathy/ Renal Artery Stenosis

Question 1

Diabetes is the most common cause of CKD. T/F?

Answer 1

T

Question 2

What is the name of the nodules found on biopsy?

Answer 2

Kimmel Stiel Wilson lesion

Question 3

Why are renal infections (pyelonephritis) more common in diabetics?

Answer 3

Higher blood sugar -> increased infections

Question 4

What is the BP target of those with diabetic nephropathy?

Answer 4

130/80mmHg

Question 5

Diabetes can also lead to renal artery stenosis. How is this imaged?

Answer 5

USS

CT angiogram

Question 6

If renal artery stenosis is deemed to be haemodynamically significant how can it be managed?

Answer 6

Stents

Percutaneous renal artery angioplasty

Question 7

If a diabetic is started on ACEi after how many days should U&Es be checked?
Why does it need to be checked?
What are you looking for?

Answer 7

ACEi can induce AKI in patients who have haemodynamically significant renal stenosis in both arteries

Checking to see if creatine has raised >20% in 10-14 days - if so stop use

Question 8

What is the cause for 10% of renal artery stenosis?
Typically occurring in young women.

How does it appear on CT?

Answer 8

Fibromuscular dysplasia

String of beads

Question 9

What can renal artery stenosis lead to?

Answer 9

Secondary hyperaldosteronism

Reduced blood flow to kidneys - increase in renin production - increase in aldosterone production