Kidneys in Systemic Disease Flashcards
4 pathogenic mechanisms for diabetic renal disease
Haemodynamic changes renal hypertrophy mesangial expansion & nodule formation proteinuria tubule-interstitial fibrosis
dx of diabetic nephropathy?
300mg albumin in 24hrs on 2 occasions separated by 3-6months
what is proteinuria range
30mg= microalbuminuria
300mg (3g)= proteinuria
mx of diabetic nephropathy
glycaemic control, HT therapy, RRT
how do ACEi/ARBs work in renal disease
cause dilation of afferent arterioles which reduce pressure on glomerulus and therefore GFR
which 2 vasculitides have renal involvement
granulomatosis w polyangiitis, microscopic polyangiitis
what is GPA?
mainly ENT symptoms- nasal crusting, rhinorrhoea, OM etc
what is microscopic polyangiitis
mainly respiratory- cough, haemoptysis, SOB
mx for vasculitis induced renal damage
immunosuprssion, plasma exchange, renal support (RRT)
50% of SLE pts have renal symptoms, these are…?
proteinuria, reduced renal function, nephrotic syndrome, granular casts
what are the classes of SLE renal damage according to biopsy
class1: minimal mesangial
class6: adv sclerosing
serological ix for SLE
+ve ANA, dsDNA, Sm AB, low complement
at which class do you use immunosuppressive mx for SLE
class 3, 4, 5- most have relapsing course
s/s of renovascular disease
AKI after HT tx (ACE/ARBs)
CKD in elderly with diffuse vascular disease
Flash Pulmonary Oedema
mx of renovascular disease
angioplasty + stent, medical therapy
