MIDTERMS: Renal Disorders Flashcards
Sudden decline in kidney function, often classified as prerenal, intrinsic, or postrenal. Common causes include ischemia, nephrotoxins, and obstruction.
Acute Kidney Injury (AKI)
Progressive loss of kidney function over months or years, often due to diabetes or hypertension. Staged based on eGFR.
Chronic Kidney Disease (CKD)
Glomerular inflammation leading to hematuria, proteinuria, hypertension, and edema. Common causes include post-infectious glomerulonephritis and IgA nephropathy.
Nephritic Syndrome
Intrinsic renal failure due to ischemia or nephrotoxins. Muddy brown casts are a hallmark finding on urinalysis.
Acute Tubular Necrosis (ATN)
Characterized by massive proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, and edema. Common causes include minimal change disease and membranous nephropathy.
Nephrotic Syndrome
Inflammatory response in the kidney interstitium, often drug-induced (NSAIDs, antibiotics). Features include fever, rash, eosinophilia.
Interstitial Nephritis
Inflammation of the glomeruli, leading to hematuria and proteinuria. Causes include immune complex deposition (e.g., IgA nephropathy, post-streptococcal GN).
Glomerulonephritis
Leading cause of CKD, characterized by nodular glomerulosclerosis (Kimmelstiel-Wilson lesions) and progressive proteinuria.
Diabetic Nephropathy
Narrowing of renal arteries, often due to atherosclerosis or fibromuscular dysplasia. Presents with refractory hypertension and an audible abdominal bruit.
Renal Artery Stenosis
Lower urinary tract infection, commonly caused by E. coli. Symptoms include dysuria, urgency, frequency, and suprapubic pain.
Acute Cystitis
Presence of blood in urine; causes include urinary tract infections (UTIs), nephrolithiasis, trauma, and malignancies.
Hematuria
Upper UTI with flank pain, fever, chills, and costovertebral angle tenderness (Murphy’s sign). Often due to ascending bacterial infection.
Acute Pyelonephritis
Non-cancerous enlargement of the prostate, leading to urinary obstruction. Symptoms include nocturia, weak stream, and urgency.
Benign Prostatic Hyperplasia (BPH)
Crystalline deposits in the renal system. Calcium oxalate is the most common type. Symptoms include flank pain, hematuria, nausea, and vomiting.
Nephrolithiasis (Kidney Stones)
Most common kidney cancer in adults. Classic triad: flank pain, hematuria, and palpable abdominal mass.
Renal Cell Carcinoma (RCC)
Most common pediatric renal malignancy. Often associated with WAGR syndrome (Wilms tumor, Aniridia, Genitourinary abnormalities, Retardation).
Wilms Tumor (Nephroblastoma)
Due to phosphate retention and decreased vitamin D activation, leading to bone pain and osteitis fibrosa cystica.
Hyperparathyroidism in CKD
Seen in CKD; leads to anemia, requiring erythropoietin-stimulating agents.
Erythropoietin Deficiency
White, crystalline deposits of urea on the skin in end-stage renal disease (ESRD) due to high uremia levels.
Uremic Frost
Exercise programs designed to improve functional capacity and quality of life in dialysis patients.
Renal Rehabilitation
Symptoms: Oliguria, fluid overload, confusion, nausea, ECG changes (hyperkalemia).
Causes: Prerenal (hypovolemia), intrinsic (ATN, glomerulonephritis), postrenal (obstruction).
Key Findings: Increased creatinine, decreased urine output, metabolic acidosis.
Acute Kidney Injury (AKI)
Symptoms: Fatigue, pruritus, edema, hypertension, uremic frost (in severe cases).
Causes: Diabetes, hypertension, glomerulonephritis.
Key Findings: Low eGFR (<60 mL/min), proteinuria, anemia, secondary hyperparathyroidism.
Chronic Kidney Disease (CKD)
Symptoms: Massive edema (initially in lower extremities), foamy urine, dyspnea.
Causes: Minimal change disease, membranous nephropathy, diabetes.
Key Findings: Heavy proteinuria (>3.5 g/day), hypoalbuminemia, hyperlipidemia, lipiduria.
Nephrotic Syndrome
Symptoms: Fatigue, pruritus, edema, hypertension, uremic frost (in severe cases).
Causes: Diabetes, hypertension, glomerulonephritis.
Key Findings: Low eGFR (<60 mL/min), proteinuria, anemia, secondary hyperparathyroidism.
Nephritic Syndrome
Symptoms: Fever, rash, eosinophilia, oliguria.
Causes: Drug-induced (NSAIDs, antibiotics), infections, autoimmune diseases.
Key Findings: WBC casts, eosinophiluria.
Interstitial Nephritis
Symptoms: Oliguria, fluid overload, confusion, nausea.
Causes: Ischemia (shock, sepsis), nephrotoxins (aminoglycosides, contrast dye).
Key Findings: Muddy brown casts in urinalysis.
Acute Tubular Necrosis (ATN)
Symptoms: Early stages asymptomatic, later proteinuria, hypertension, edema.
Key Findings: Kimmelstiel-Wilson nodules on biopsy, progressive albuminuria.
Diabetic Nephropathy
Symptoms: Dysuria, urgency, frequency, suprapubic pain.
Causes: E. coli (most common), Staph saprophyticus.
Key Findings: Positive leukocyte esterase, nitrites in urine.
Acute Cystitis (Bladder Infection)
Symptoms: Fever, chills, flank pain, costovertebral angle tenderness (Murphy’s sign), dysuria.
Causes: Ascending infection (E. coli, Proteus, Klebsiella).
Key Findings: WBC casts in urinalysis.
Acute Pyelonephritis
Symptoms: Refractory hypertension, flash pulmonary edema, audible abdominal bruit.
Causes: Atherosclerosis (older males), fibromuscular dysplasia (younger females).
Key Findings: Renal angiography (gold standard).
Renal Artery Stenosis
Symptoms: Nocturia, weak urine stream, incomplete emptying, urgency.
Key Findings: Smooth, firm, elastic prostate on DRE, increased PSA.
Benign Prostatic Hyperplasia (BPH)
Symptoms: Blood in urine (gross or microscopic).
Causes: UTI, nephrolithiasis, trauma, malignancy.
Key Findings: RBCs in urine, possible casts.
Hematuria
Symptoms: Bone pain, fractures, osteitis fibrosa cystica.
Causes: Phosphate retention, vitamin D deficiency.
Key Findings: Elevated PTH, calcium-phosphate imbalance.
Hyperparathyroidism in CKD
Symptoms: Classic triad (flank pain, hematuria, palpable mass), weight loss.
Risk Factors: Smoking, obesity, von Hippel-Lindau syndrome.
Key Findings: Solid renal mass on imaging.
Renal Cell Carcinoma (RCC)
Symptoms: White powdery urea deposits on skin in ESRD.
Cause: Severe uremia due to CKD.
Uremic Frost
Symptoms: Severe flank pain radiating to groin, hematuria, nausea, vomiting.
Types: Calcium oxalate (most common), uric acid, struvite, cystine.
Key Findings: CT scan (gold standard).
Nephrolithiasis (Kidney Stones)
Symptoms: Abdominal mass in children, hypertension, hematuria.
Key Findings: Associated with WAGR syndrome (Wilms, Aniridia, GU defects, Retardation).
Wilms Tumor (Nephroblastoma)
