Kidney Flashcards
3 forms of urinalysis and common contaminants
Visual analysis
Test sticks
Microscopic
Common: Leukocytes Blood Ketone Glucose Protein Bilirubin pH Transitional cells Bacteria
Renal function tests (3) to determine GFR- Glomerular filtration rate. Volume of fluid filtered by glomeruli.
- Inulin. Gold standard. Give IV infusion of plant starch. Completely filtered by glomerulus. Can get accurate GFR.
- Creatinine clearance rate. Compare blood levels to urine. Will slightly overestimate GFR
- Blood urea nitrogen (BUN) protein and DNA breakdown byproduct.
Azotemia
No clinical signs of renal failure present.
Only labs are abnormal- decreased GFR, increased BUN, increased blood creatinine.
Usually discovered on accident.
Uremia
Azotemia + clinical signs and symptoms of renal failure
Ex: HTN, anemia, edema, oliguria
Oliguria
Low GFR= reduced ability to produce urine.
Renal disease is #__ cause of death
9
Nephritic vs nephrotic
Nephritic: Blood in urine. Hematuria.
Nephrotic: Proteins in urine. Proteinuria.
Nephrotic syndromes
Diabetic nephropathy (50%) Minimal change disease
Proteinuria - foamy urine from albumin.
No hematuria
May resolve completely or progress to ESRD.
Which is more severe? Nephritic or nephrotic?
Nephrotic.
Diabetic nephropathy (nephrotic syndrome)
- Most common cause of __
- Leading cause of death in ___
- MOA
- Characterized by
- Risk factors
Most common cause of renal disease
Leading cause of death in T1 DM
MOA: Endothelial glycation = basement membrane damage
Characterized by nephrotic syndrome, diffuse glomerulosclerosis.
Risk: Type 1 DM, HTN, smoking, Race (AA, hispanic)
Tx: Dialysis, DM treatment
Minimal change disease (nephrotic syndrome)
- Most common cause of nephrotic syndrome in __
- Cause?
- First symptom/sign
- How to visualize pathology
- Treat with what
Most common cause of nephrotic syndrome in children. 80-90% children, 10-20% adults
70-90% idiopathic cause.
Edema of face is first sign
Pathology visible with electron microscopy- podocytes, microvilli, vacuoles.
Treat with steroids- 95% recover
Acute tubular necrosis
- What is it
- Most common cause of what
- Two types
- Extensive necrosis of tubular epithelial cells.
- Most common cause of ACUTE renal failure.
- Glomeruli are spared.
- Ischemic (50%), toxic (25%)
Most common cause of acute renal failure
Acute tubular necrosis
Most common cause of nephrotic syndrome in children
Minimal change disease
Most common cause of renal disease
Diabetic nephropathy due to T1 DM