Post Renal Disease Flashcards
How common is post renal disease in comparison to pre and renal disease?
- least common
- accounts for only 5% of kidney disease
What is post renal disease?
- obstruction of urine flow from the kidneys
Where are the 3 locations post renal disease can occur?
1 - ureters
2 - bladder
3 - urethra
Post renal disease is an obstruction that can occur in the ureterm bladder or urethra. The obstruction can occur intraluminal or intramural, what does that mean?
- intraluminal = within the lumen
- intramural = within the walls
What are some of the most common causes of post-renal disease?
- kidney stones
- tumours both intrinsic and extrinsic
- fibrosis
Is post renal disease more common in men or women?
- twice as common in men
Is post renal disease reoccurance common?
- yes
- up to 50% re-occurance after 5 years
Kidney stone formation begins with oversaturation, what does this mean?
- solutes (waste products, electrolytes, etc.) in urine become too concentrated
- can occur in dehydrated states
In kidney stone formation the urine becomes oversaturated, what happens next?
- concentrated solutes precipitate forming small crystals
- the crystal then grows and larger crystals come together forming larger crystals called a stone
How can post-renal obstruction be diagnosed non-invasively?
- imaging techniques of Kidney Urinary Bladder (KUB)
- CT scan (non contrast)
- intravenous Urography/CT Urography
Urinary bladder carcinoma is a common cause of post-renal disease. Is it more common in men or women?
- men
Urinary bladder carcinoma is a common cause of post-renal disease. 90% of bladder carcinoma are urothelial and 10% are non-urothelial in their origin. What does urothelial mean?
- urothelial means transitional cells are affected
- non-urothelial means squamous cell, adenocarcimona and small cell are affected
Urinary bladder carcinoma is a common cause of post-renal disease. 90% of bladder carcinoma are urothelial and 10% are non-urothelial in their origin. Although rare, in Egypt non-urothelial bladder cancer is more common due to a parasitic infection of bladder called what?
- schistosomiasis (sch-stow-sir-mia-uh-sis)
- schistos’ that means ‘split’ and ‘soma’ that means ‘body
Bladder cancer can be a common cause of post-renal disease. What are the 2 most common risk factors for bladder cancer?
1 - smoking
2 - occupational exposure to naphthylamine (formerly used in dyes to make paint and in rubber industry)
Bladder cancer can be a common cause of post-renal disease. What do patients commonly present with?
- painless haematuria (blood in urine)
- can present with painful micturition (dysuria), urgency, hydronephrosis (swollen kidneys)
Bladder cancer can be a common cause of post-renal disease. What is the prognosis for bladder cancer?
- depends upon the tumour grade and stage (TNM staging)
- can have good prognosis though
- has a high rate of recurrence
Prostate cancer is a common cause of post-renal disease. What is the most common prostate cancer that causes a post renal obstruction?
- benign prostatic hyperplasia
Prostate cancer is a common cause of post-renal disease. The most common prostate cancer that causes a post renal obstruction is benign prostatic hyperplasia. How common is this?
- ubiquitous in older men
- 60% at age 60; 80% at age 80
- not all develop obstuction though
In the H&E stain below there is the common signs of Kimmelsteil Wilson lesions. Although biopsy in this group of patients with chronic kidney disease is rare, what condition does this patient have?
- diabetes
What is autosomal dominance?
- affecting non sex chromosomes
- dominant meansd only a single gene can cause the disease
Peritoneal dialysis and hemodialysis are both options for patients. Which is more common?
- hemodialysis
- safer
When patients recieve a transplant, the transplanted organ is placed in the iliac fossa, becoming extraperitoneal. When does the new kidney recieve its blood supply from?
- common iliac artery and vein
