Pathology of AKD Flashcards
most common cause of AKI in adults
ATN
two categories of ATN
ischemic- hemorrhage, shock, burns, HF, diarrhea
nephrotoxic- drugs like aminoglycosides, organic solvents, poisons
histo of tubular obstruction
proteinaceous debris in many tubule lumens
describe light chain cast nephropathy
often from myeloma
light chains cross glomerular cap walls and damage tubules, cause obstruction
describe the pathogenesis of ATN
afferent constriction (shunting blood)
decreased glomerular ultrafiltration coefficient
backleak out of tubule
cellular degredation and obstruction
what is seen in urine w/ pyelonephritis
PMN urine casts
why would tubular damage also occur w/ pyelonephritis
interstitial inflammation separates tubules from peritubular capillaries- loss of blood supply
what pattern do PMN pyelonephritis infections take
microabcesses in parenchyma
most common drug causes of acute hypersensitivity tubulointerstitial nephritis
NSAIDs, diuretics, antibiotics (beta lactams like synthetic penicillins and cephalosporins)
role of steroids w/ allergic interstitial nephritis
dont cause any inflammation, used for treatment
cells that can be present w/ allergic tubulointerstitial nephritis
monocyte leukocytes and sometimes eosinophils
common origin of cholesterol emboli
abdominal aorta
why are cholesterol emboli so bad in kidney
provoke an immediate inflammatory response- nephrons downstream will be damaged by the inflammation or ischemia via obstruction
describe manifestations of thrombotic microangiopathy
disease of small vessels, causes thrombosis, thrombocytopenia, microangiopathic hemolytic anemia
schistocytes on peripheral smear
hemolytic uremic syndrome triad
- hemolytic anemia
- thrombocytopenia
- uremia (toxicity caused by renal failure)
