inherited disorders of kidney Flashcards

1
Q

what are the two types of polycystic kidney disease

A
  • autosomal dominant

- autosomal recessive

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2
Q

which gene mutation is the autosomal dominant polycystic kidney disease found on

A

PKD1 gene on chromosome 16 (most common)

PKD2 mutations on chromosome 4 (less common)

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3
Q

which gene group of ADPKD are more likely to develop end stage kidney failure

A

PKD1

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4
Q

pathophysiology of ADPKD

A
  • massive cyst enlargement

- epithelial lined cysts arise from a small population of renal tubules

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5
Q

clinical features of ADPKD

A
  • reduced urine concentration
  • chronic pain
  • hypertension
  • haematuria
  • cyst infection
  • renal failure
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6
Q

extra-renal clinical features of ADPKD

A
  • hepatic cysts
  • intra-cranial aneurysms
  • cardiac disease (valve prolapse, valvular disease)
  • diverticulitis
  • colonic perforation
  • hernias
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7
Q

diagnosis of ADPKD

A
  • USS (CT/MRI unclear on USS)

- genetic (mutation analysis)

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8
Q

what is this

A

cystic kidney on CT

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9
Q

what is this

A

cystic calcification on X-ray

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10
Q

are cerebral aneurysms common in children with ADPKD

A

no

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11
Q

management of ADPKD

A
  • manage hypertension
  • hydration
  • proteinuria reduction
  • Tolvaptan to reduce cyst volume and progression
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12
Q

treatment for renal failure

A
  • dialysis

- transplantation

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13
Q

who gets autosomal recessive kidney disease

A

young children and constantly associated with hepatic lesions

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14
Q

where is the gene for ARPKD found

A

PKDH1 on chromosome 6

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15
Q

clinical presentation of ARPKD

A
  • varies depending on the renal/liver lesions
  • kidneys always palpable
  • hypertension
  • recurrent UTI’s
  • slow decline in GFR
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16
Q

what is alports syndrome a disorder of

A

type IV collagen matrix

17
Q

presentation of Alports

A
  • haematuria
  • proteinuria
  • sensorineural deafness
  • ocular defects (anterior lenticonus)
  • leiomyomatosis of oesophagus/genitalia
18
Q

diagnosis for Alports

A

suspect in patients with microscopic haematuria +/- hearing loss
-renal biopsy (variable thickness GBM)

19
Q

treatment for Alports

A

no specific treatment

  • standard aggressive treatment of BP and proteinuria
  • dialysis/transplantation
20
Q

what is anderson fabrys disease

A

inborn error of glycosphingolipid metabolism

  • affects lysosomal storage in kidneys, liver, lungs, erythrocytes
  • uncommon
21
Q

presentation of anderson fabrys disease

A
  • renal failure
  • angiokeratomas
  • cardiomyopathy
  • valvular disease
  • stroke
  • acroparaethesia
  • psychiatric
22
Q

diagnosis of Fabrys

A
  • plasma/leukocyte
  • renal biopsy
  • skin biopsy
23
Q

treatment for anderson fabrys

A
  • enzyme replacement (fabryzyme)

- managment of complications

24
Q

what is medullary cystic kidney disease

A

morphologically abnormal renal tubules leading to fibrosis

-cysts are in the corticomedullary junction/medulla

25
Q

when does medullary cystic kidney disease present

A

average age is 28 years

26
Q

choice of treatment for medullary cystic kidney

A

renal transplant

27
Q

diagnosis of medullary cystic kidney

A

family history

CT scan

28
Q

what is medullary sponge kidney

A
  • dilation of collecting ducts

- cysts have calculi