Nephrology Flashcards
what is diagnostic of goodpasture syndrome
linear pattern of IgG deposition against glomerular basement membrane
Goodpasture syndrome triad
acute glomerulonephritis
pulmonary alveolar haemorrhage
circulating anti GBM antibodies
nephronophthisis
AR
causes medullary cystic kidney disease (small kidneys b/l on US)
leading cause childhood ESRD
presents with polyuria and polydipsia
When is renal biopsy indicated in HSP
proteinuria - UPCR >200, increasing trend >4/52 after diagnosis
nephrotic syndrome - low alb, oedema and heavy proteinuria
nephritic syndrome - HTN, haematuria, rapidly deteriorating renal function
HTN
Macroscopic haemturia with proteinuria
Cystinosis
AR
failure to thrive
recurrent vomiting
metabolic acidosis
hypo K
dehydration
grade of VUR
I: urine tracks into ureter non dilation
II: urine tracks into renal pelvis, no dilation
III: mild-moderate dilatation of ureter only
IV: ureteral tortuosity, with pelvicalyceal dilatation
V: gross dilatation and ureteral tortuosity with blunted fornices
nephrotic syndrome triad
oedema
proteinuria
hypoalbuminaemia
most common type nephrotic syndrome
primary idopathic (90%)
of this 85-90% minimal change disease, carries best prognosis
10-15% focal segmental glomerulosclerosis 10-15%
management of nephrotic syndrome
steroids - pred minimum 16 weeks
penicillin prophylaxis
PPI
when is nephrotic syndrome classes as steroid resistant
doesn’t respond to 28days of treatment with prednisolone
all steroid resistant require biopsy
distal renal tubular acidosis type I vs type IV
I:
reduced H excretion in distal tubule
urine ph >5.5 - can never acidify
nephrocalcinosis
plasma hCO3 <10
low-normal plasma K
high urine ca/cr ratio
IV:
impaired aldosterone action causing reduced H and NH3 excretion
urine Ph >5.5
plasma HCO3 >15
high plasma K
normal urine ca/cr ratio
signs pre renal failure over ATN
return of renal function to baseline within 24-72 hrs after fluids
urinary na concentration <20
HSP - histology
small vessel vasculitis - skin, GI, kidneys and joints
deposits of IgA in mesangium
AD polycystic kidney disease
multiple renal cysts
commonest inherited nephropathy
PKD1 on chromosome 16