Kidney Flashcards
Causes of ATN=Broad causes
Pre-renal (sepsis, hypovolemia-dehydration)
Toxic
6 Toxins cause ATN
- Contrast
- Meds.
- Ca oxalate from ethylene glycol poisoning
- Urate crystal/stones
- Myoglobinuria
- Hemoglobinuria
Meds. cause ATN
“ATN”=
- AG
- NSAIDs
- amphoTericin B
Myoglobinuria caused by
Crush injury
Urate crystals/stones caused by
Tumor lysis syndrome–uric acid stones
Hemoglobinuria caused by
blood transfusion
RBC casts
Glomerulonephritis, malignant hypertension.
WBC casts
Tubulointerstitial inflammation, acute pyelonephritis, transplant rejection.
Fatty casts (“oval fat bodies”)
Nephrotic syndrome. Associated with “Maltese cross” sign.
Granular (“muddy brown”) casts
Acute tubular necrosis.
Waxy casts
End-stage renal disease/chronic renal failure.
Generalized reabsorptive defect in PCT.
Fanconi syndrome
May result in metabolic acidosis (proximal renal tubular acidosis).
Fanconi syndrome
Associated withexcretion of nearly all amino acids, glucose, HCO3 , and PO4 .
Fanconi syndrome
Presents similarly to chronic loop diuretic use.
Bartter syndrome
Reabsorptive defect in thick ascending loop of Henle. Autosomal recessive. Affects Na+/K+/2Cl– cotransporter.
Bartter syndrome
Reabsorptive defect of NaCl in DCT.
Gitelman syndrome
Similar to using lifelong thiazide diuretics.
Gitelman syndrome
Gain of function mutationinc.Na+ reabsorption in collecting tubules (inc.activity of epithelial Na+ channel).
Liddle syndrome
Presents like hyperaldosteronism, but aldosterone is nearly undetectable.
Liddle syndrome
Liddle syndrome tx.
Amiloride
Potter sequence facial anomalies
low-set ears and
retrognathia,
flattened nose
Potter sequence (syndrome) 6 sxs (Mnemonic)
limb deformities,
facial anomalies,
compression of chest and
pulmonary hypoplasia
"POTTER" sequence associated with: Pulmonary hypoplasia Oligohydramnios (trigger) Twisted face Twisted skin Extremity defects Renal failure (in utero)
pulmonary hypoplasia in potter seq due to
lack of amniotic fluid aspiration into fetal lungspulmonary hypoplasia
(cause of death). in Potter sequence
pulmonary hypoplasia
Cause of Potter seq.
“Babies who can’t “Pee” in utero develop Potter”
=kidney problems
ARPKD, obstructive uropathy (eg, posterior urethral valves), bilateral renal agenesis, chronic placental insufficiency.
AT II Effect on kidney BV’s
constrict efferent arteriole
ACEi effect on kidney BV’s
dilate efferent arteriole (inhibits efferent a. constriction by AT II), so decr. GFR but decr. BP by inhib. Aldosterone release
Ions re-absorbed in PCT
Na+, glucose, aa, K+, Cl-, uric acid, H2O, Phosphate, Bicarb.
Ions secreted in PCT
H+
ATII action on PCT: reabsorbs what 3 and secretes what 1 ion?
Bicarb., H2O & Na+ reabsorption and H+ excretion=Contraction ALKalosis
Thick ascending loop reabsorbs?
Na+/K+/Cl- & Mg2+/Ca2+