Nephrotic Flashcards
qualifications for nephrotic syndrome / consequences
urine protein over 3.5 g/day hypoalbuminemia - edema hypogammaglobulinemia- infection hypercoaguable state- loss of AT III hyperlipidemia - fatty casts
MCD
m/c in kids, selective loss of albumin, due to massive cytokine release that causes effacement of foot processes, meds respond to steroids, adults may not
gene assoc with rare cases of MCD/FSGS
NPHS2 (podocin)
microscopic findings in MCD
EM- effacement of foot processes
FSGS
m/c in AA and hispanic adults, non-selective protein loss, poor response to steroids
associations with FSGS (3)
heroin, HIV, sickle cell
microscopic findings in FSGS
LM- focal/segmental hyalinosis
EM- effacement of foot processes
membranous nephropathy
m/c in caucasian adults, autoantibodies directed at podocytes, loss of ATIII (hypercoaguable)
associations with membranous nephropathy (5)
HBV, HCV, solid tumors, SLE, drugs (gold, penicillamine, NSAIDs)
microscopic findings in membranous nephropathy
LM- thick glomerular BM
EM- subepithelal, spike and dome
IF- granular
membranoproliferative GN “apperance”
tram track
MPGN type I location of deposits, assoc
deposits- sub endothelial
assoc- HBV, HCV
MPGN type II location of deposits, assoc
deposits- intra-BM
assoc- C3 nephritic factor (low serum C3)
microscopic findings in MPGN I/II
LM: thick BM, hypercellular mesangium
EM: I- subendo, II- intra-BM
IF: granular
m/c cause of ESRD in the US
DM
pathogenesis of diabetic nephropathy
high glucose leads to hyaline arteriolosclerosis, affects efferent arteriole more, hyper filtration occurs, progresses to nephrotic syndrome
microscopic findings in DM nephropathy
KW nodules
first lab elevated in DM nephropathy
microalbumin
AL, AA
AL- blood cell dyscrasia, idiopathic
AA- chronic inflammation
microscopic findings in renal amyloidosis
apple green birefringence on congo-red staining
characteristic change for diffuse proliferative GN
wire loop
2 m/c causes of asymptomatic hematuria
IgA nephropathy, benign familial hematuria (thin BM disease)
cells that proliferate in MPGN
mesangial cells
medullary sponge kidney
linear striations, small cysts
AD PKD is assoc with defects in
polycystin
nephronophthisis
AR defect in kids. NPHP1
