kidney anomalies-renovascular disease Flashcards
most common congenital renal anomaly
horseshoe kidney
3 features of Potter sequence/cause
flat face/low set ears
lung hypoplasia
extremity defects
due to oligohydraminos
unilateral renal agenesis is associated with:
hyperfiltration and risk of renal failure later in life
how is cystic renal dysplasia differentiated from polycystic kidney disease? (3)
CRD is usually unilateral, cysts are in parenchyma, cysts contain abnormal tissue (cartilage)
AR PCKD gene
PKHD1 (fibrocystin)
appearance of cysts in AR PCKD
radial, span from capsule or cortex
extra-renal abnormalities in AR PCKD (1)
hepatic fibrosis/cysts
3 presenting symptoms of AD PCKD
hypertension, hematuria, progressive renal failure
AD PCKD gene
APKD1
extra-renal abnormalities associated with AD PCKD
berry aneurysm
mitral valve prolapse
hepatic cysts
m/c location of ectopic kidney, m/c complication
pelvis/ureter obstruction
Pre-renal ARF
cause, BUN:Cr, FENa, Urine Osm
decreased renal perfusion, ratio over 15, FENa under 1%, Urine Osm over 500
Post-renal ARF
cause, BUN:Cr, FENa, Urine Osm
obstruction of urine outflow, late = ratio ~ 15, FENa over 2%, Urine Osm under 500
m/c cause of intra-renal ARF
acute tubular necrosis
ATN
cause, BUN:Cr, FENa, Urine Osm
ischemic or nephrotoxic cause, ratio ~ 15, FENa over 2%, urine osm under 500
characteristic finding on urine micro in ATN
brown, granular casts
most affected portion of nephron in ischemic ATN
PCT, TAL (require most ATP)
most affected portion in nephrotoxic ATN
PCT (most exposure to agent)
most common cause of nephrotoxic ATN
aminoglycosides
acid-base abnormality associated with ATN
anion gap metabolic acidosis with hyperkalemia
what is AIN?
drug-induced hypersensitivity reaction that damages the connective tissue between tubules
prevention of AIN
fever, rash and oliguria after new med started
characteristic finding in urine for AIN
eosinophils
presentation of renal papillary necrosis
gross hematuria and flank pain
predisposing to renal papillary necrosis (4)
analgesic abuse, DM, SCD, severe pyelo
BP that predisposes to benign nephrosclerosis
SBP over 140 chronically
typical finding in benign nephrosclerosis
small kidneys bilateral, hyaline arteriolosclerosis
BP that predisposes to malignant nephrosclerosis
DBP over 130
typical findings in malignant nephrosclerosis (3)
fibrinoid necrosis, onion skinning, flea bitten
2 etiologies of renovascular hypertension
renal artery stenosis, fibromuscular dysplasia
what is the typical patient with fibromuscular dysplasia?
young woman
