Glomerular and Tubulointerstitial Disease Lecture Powerpoint Flashcards
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BUN will have increased concentration if…
…there is decreased blood flow to kidney
Creatinine will only increase if there is….
…significant kidney damage
Azotemia definition
Presence of elevated BUN
Uremia definition
Advancing azotemia with increased BUN and Cr, indicates renal failure
Vasopressor definition
The name of the local paracrine factor secreted by macula densa cells to communicate with juxtaglomerular cells thru mesangial cells indicating the JG cells need to release renin
When blood pressure is too high, macula densa cells can secrete ___ that inhibit ___ release from JG cells
Paracrine factors, renin
Nephrotic syndrome results from injury to the ___ (cells) while nephritic syndrome is ____ based, involving ____
Podoctyes, inflammation, blood in the urine
Most nephrotic syndromes have a ___basis
Immunologic
Does antibiotic treatment prevent glomerular disease in post strep glomerulonephritis?
Nope, immune mediated doesn’t have to do when treatment was sought after
A strep infection often goes on to cause either ____ or ____ but rarely both
rheumatic fever, acute glomerulonephritis
Treatment of post strep glomerulonephritis (3)
- supportive diuretics
- control hypertension
- dialysis in extreme cases
Prognosis of post strep glomerulonephritis
Very good, see recovery often within 2 months
Goodpasture’s syndrome definition
A type II hypersensitivity invoolving antibody formation against the glomerular basement membrane, rapidly progressive to renal failure
Most common glomerular cause of hematuria
IgA nephropathy/berger’s disease
IgA nephropathy/berger’s disease definition
Attacks of hematuria following nonspecific illness, exercise, or immunization that is benign and result of excessive IgA antigen complex formation
IgA nephropathy/berger’s disease treatment (2)
- supportive care of hypertension
- steroids if progressive to suppress immune response
Rapidly progressive glomerulonephritis (RPGN) definition
Acute glomerulonephritis marked by rapid loss of renal function >50% over a period of 3 months with renal crescents upon biopsy
75-80% of all nephrotic syndromes in kids and 20% in adults is from…
…minimal change disease
Minimal change disease definition
Nondamaging cause of proteinuria leading to nephrotic syndrome, sometimes seen with allergies, malignancies, or certain drugs
Minimal change disease presents as ___onset of nephrotic syndrome
abrupt
Focal segmental glmoerulosclerosis definition
Scarring of some of the glomeruli of the kidney either idiopathic or due to infection, or drug, or a disease
Focal segmental glmoerulosclerosis prognosis
Poor
Most common primary cause of nephrotic syndrome in adults is…
…membranous glomerular disease
Captopril drug class
ACEI
Causes of membranous glomerular disease are typically ___ and include (3), how does it present (3)?
Autoimmune
- nephrotic syndrome
- cancers
- Hep B
Presents with proteinuria and sometimes hematuria or malaise
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Membranoproliferative glomerulonephritis (MPGN) results in ___ GFR and ____ mesangial cellularity
decreased, increased
Mostcommon cause of end stage renal disease in US
Diabetes
Kimmelsteil Wilson lesion definition
Hallmark change seen in kidney from mesangial matrix expansion, nodular appearance indicative of glomerulonephropathy from diabetes
Cortical nephrons focus on controlling ____ while medullary ones are focused on ____
BP, reabsorption
Acute interstitial nephritis definition, what 3 things does it lack compared to glomerular disease?
Acute decline in renal function due to inflammation of the nephron, lacks HTN, proteinuria, or edema unlike glomerulonephritis
Acute interstitial nephritis triad
- fever
- skin rash
- peripheral eosinophilia
Acute interstitial nephritis can present as TINU syndrome, which is…
…tubulointerstitial nephritis and uveitis syndrome
Acute interstitial nephritis urine appears…
…coke colored
Causes of acute interstitial nephritis (4)
- antibiotis
- NSAIDS
- systemic infections
- autoimmune
Chronic tubulointerstitial nephropathy definition, what does it frequently present with?
Disease of the nephron tubule, frequently presents with hyperkalemia
Sequelae of chronic tubulointerstitial nephropathy
Fanconi syndrome
Fanconi syndrome definition
dysfunction of proximal tubules of kidney resulting in renal glycosuria, water and bicarb loss, and metabolic acidosis
