Harrison's 308 - Nephrotic & Nephritic Syndromes Flashcards
Criteria of Nephrotic Syndrome: \_\_\_\_ < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypo\_\_\_\_\_\_\_\_\_\_\_ Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyper\_\_\_\_\_\_ (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly \_\_\_\_\_\_) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hyper\_\_\_\_\_\_
Criteria of Nephrotic Syndrome: 3.5 g/day < Proteinuria Hypoalbuminemia Hyperlipidemia (Mostly Periorbital) Edema Hypertension
If 3.5 g/day < Proteinuria is present without all the other criteria of Nephrotic Syndrome. The most probable cause will be -
Advanced Diabetes Mellitus
In Nephrotic Syndrome, There is a inverse relationship between the severity of Proteinuria and ___.
In Nephrotic Syndrome, There is a inverse relationship between the severity of Proteinuria and GFR.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to __, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
______ _________ ______
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or _____, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see ________ of _______ and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to _______.
Minimal Change Disease
Nephrotic Syndrome causing disease that can be Primary or Secondary to HL, Allergies or NSAIDs, in IM we see Effacement of Podocytes and on Uranalysis there is selective proteinuria. In children (~90% of patients) it is very responsive to Steroids.
_____ _________ ____________
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, _____and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and ________ as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, ________ and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. __% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with _______ and ACEi.
Focal Segmental Glomerulosclerosis
Nephrotic Syndrome causing disease that can be Primary or Secondary to HIV, HBV, PVB19 and Hypertension as well as Analgesics, Bisphosphonates and Radiation. It involves mostly Corticomedullary Junction Glomeruli. 50% of patients will reach CRF in 6 years. it is treated carefully with Cyclosporine and ACEi.
___________ _____________
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in ___, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, _____, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to ______, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a ______ glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, Ig_ and __ deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic _________. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for _____________ events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and ________.
Membranous Glomerulonephritis
Nephrotic Syndrome causing disease that is more common in Men, often due to Malignancy, HBV, Malaria, SLE or RA. It Involves a thickened glomerular membrane (IF-Granular), non-selective proteinuria, IgG and C3 deposits and microscopic hematuria. High risk for thromboembolic events. Treated with immunosuppressants; Cyclophosphamide, Steroids and rituximab.
_________
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on _____ _____ stain an apple green birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an _____ ______ birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the mesangium.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the _______.
Amyloidosis
Nephrotic Syndrome causing disease that is mostly part of systemic amyloid deposition. On light microscopy we can see on Congo red stain an apple green birefringence under polarized light in the mesangium.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common ___ cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on ___. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual _______. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and ________-_____ _______. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t _______ the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ____/ ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ___ but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
_______ __________
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.
Diabetic Nephropathy
Nephrotic Syndrome causing disease that is the most common CHF cause in DM patients, and the cause of ~45% of all patients on RRT. Pathogenesis involves Thickening of BM, Mesangium Dilation and eventual sclerosis. There is direct correlation between retinopathy and Kimmelsteil-Wilson Nodules. It is the only GN disease that doesn’t shrink the kidney. Treated with ACEi / ARB but never both.