Renal 1 Flashcards
Name the 3 main categories of clinical renal syndromes discussed in class and their major findings
- Acute renal failure: oliguria and rapid rise in serum creatinine
- nephrotic syndrome: proteinuria >3.5 g
- nephritic syndrome: hematuria
What is the basic functional unit of the kidney?
nephron
How can you tell proximal vs distal convoluted tubules when looking at the kidneys?
in the proximal convoluted tubules the “brush” border has sloughed and can be seen in the lumen; thus, the lumen appears partially filled.
Acute renal failure is due to _______ (anatomic location) injury
tubular
Nephrotic syndrome is due to __________ defects
glomerular capillary filtration defects
nephritis is due to breaks in the ______ loops
glomerular capillary
Name 3 causes of acute renal failure
- acute tubular necrosis
- acute interstitial nephritis
- acute pyelonephritis
Name 3 causes of nephrotic syndrome
- membranous nephropathy
- focal segmental glomerulosclerosis
- minimal change disease
Name 3 types of acute nephritic syndrome
- crescentic glomerulonephritis
- lupus nephritis (proliferative type)
- post-infectious glomerulonephritis
Name 2 causes of “isolated hematuria”
- IgA nephropathy
2. Alport’s disease
T/F- if untreated or non-responsive, acute renal failure, nephrotic syndrome, and nephritic syndrome can all progress to chronic renal failure
True
Name 3 common histological findings of chronic renal failure
- glomerular sclerosis
- interstitial fibrosis
- tubular atrophy
What type of IF pattern would you see in Anti-GBM disease?
linear capillary loop patterns
What type of IF pattern would you see in membranous nephropathy or lupus nephritis?
Granular capillary loop pattern
What type of IF pattern would you see in IgA nephropathy or Lupus nephritis?
mesangial pattern
Lupus nephritis can display what two types of IF staining?
mesangial or granular capillary loop pattern
What is a podocyte?
glomerular epithelial cell
What are two main classifications or mechanisms of glomerular injury?
- immune mechanisms
- immune complex (e.g. membranous glomerulonephropathy)
- T-cell mediated (e.g. minimal change disease) - non-immune mechanisms (genetic structural disorders e.g. Alports syndrome)
What disease is caused by a mutation in type IV collagen gene causing structural weakness to the GBM which is composed of type IV collagen?
Alport’s sydnrome
What do they mean by focal vs diffuse vs global vs segmental?
Glomerular changes can be focal (<50% of all glomeruli) or diffuse (in all or almost all the glomeruli), and segmental (only a part of the glomerulus) or global (the entire glomerulus).
Name two causes of acute pre-renal failure
- cardiac shock
2. dehydration
Name one cause of post-renal acute renal failure
- obstructive stone
Name the general example given in class for the cause of acute intrarenal failure
tubulointerstitial diseases (acute tubular necrosis, acute interstitial nephritis, acute pyelonephritis)
T/F- renal tubular disease can occur secondary to severe glomerular diseases?
true
What is the most common cause of acute renal failure?
ATN
Is ATN usually reversible?
yes (very often)
What are two common causes of ATN?
- hypovolemia/ischemia
- drug toxicity
What will you see histologically in ATN?
- necrotic debris in tubules
- dilated tubules with flattened epithelium
Most common cause of AIN?
DRUG INDUCED
- antibiotics
- NSAIDs
Symptoms of AIN?
- fever, rash, eosinophilia
- rising serum creatinine and oliguria
If you see eosinophils in the interstitial what should you suspect as the cause?
DRUGS
T/F- acute pyelonephritis presents very similar in appearance histologically to AIN but the inflammatory infiltrates in pyelonephritis include numerous neutrophils
true
If you have chronic pyelonephritis, what organ will your kidney begin to resemble?
The atrophic tubules look like the thyroid gland architecture and so sometimes called “thyroidization”
