Renal Flashcards
How is alports syndrome inherited?
X linked dominant
Why might patients with alport’s syndrome have a failing renal transplant?
Anti GBM antibodies
What does the renal biopsy of alports show
Splitting on the lamina densa resulting in a bsket weave appearance (only seen on electron microscopy)
What collagen is defective in alports syndrome?
Type 4
What are the common drug causes of acute interstitial nephritis?
Penicillin Rifampicin NSAIDs Allopurinol Furosemide
Features of acute interstitial nephritis?
Fever, rash, arthralgia, eosinophilia, mild renal impairment
Sterile pyuria with white cell casts.
What is the best medication for lupus nephritis (maintenence treatment)
Mycophenolate
What are the classes of lupus nephritis?
1: Normal
2: Mesangial glomerulonephritis
3. focal segmental proliferative glomerulonephritis
4.Diffuse proliferative glomerulonephritis
5. Diffuse membranous glomerulonephritis
C6. Sclerosisng glomerulonephritis
What renal disease has the highest rate of recurrence after transplant?
Membranoproliferative glomerulonephritis (particular type 2)
Treatment for dialysis disequilibrium syndrome
Hypertonic saline
What renal disease does heroin cause?
Focal segmental glomerulosclerosis
What renal disease does hepatitis B cause?
Membranous nephropathy
What renal disease does hepatitis C cause?
Membranoproliferative glomerulonephritis or membranous nephropathy
When does acute graft failure occur?
Less than 6 months
What causes acute graft failure of a kidney transplant?
Mismatched HLA
Why is there an increased risk of clots in nephrotic syndrome?
Loss of antithrombin 3 and plaminogen in the urine.
high plasma osmolality and low urine osmolality
Diabetes insipidus
Treatment of diabetes insipidus?
Cranial - desmopresson
Nephrogenic -thiazides
Treatment of central diabetes insipidus?
Desmopressin
Podocyte fusion
Minimal change disease
Management of minimal change disease
Steroids
Cyclophosphamide is the next step if steroid resistant
Prognosis of minimal change disease?
1/3rd have one episode
1/3rd have infrequent relapse
1/3rd have frequent relapses which stop before adulthood
Criteria for diagnosis of AKI?
Rise in creatanine of 26 or more in 48 hours OR 50% rise in creatanine over 7 days OR fall in urine output to less than 0.5ml.kg/hour for more than 6 hours OR 25% fall in eGFR in children in 7 days,
Causes of membranous glomerulonephritis?
idiopathic (anti phospholipase A2 antibodies)
Infections (hepB, malaria, syphillis)
Malignancy
Drugs (gold, penicllamine, gold, NSAIDS)
Autoimmune disease (SLE, thyroiditis, rheumatoid
Treatment of membranous glomerulonephritis
ACE inhibitor or ARB
Immunosupression only used in severe or progressive disease (steroids + cyclophosphamine)
Prognosis of membranous glomerulonephritis
1/3rd - spontaneous remission
1/3rd - remain prpteinuric
1/3rd - develop end stage renal failure
Most common renal disease in SLE?
Diffuse proliferative glomerulonephritis (most common and most severe)
Wire loop appearance on renal biopsy
Diffuse proliferative glomerulonephritis
Causes of membranoproliferative gomerulonephritis type 1
Cryoglobulinaemia, hepatitis C
What is fanconi syndrome?
A general reabsorptive disorder of renal tubular transort in the proximal convoluted tubule that causes tyoe 2 renal tubular acidosis
Causes of focal segmental glomerulosclerosis ?
Idiopathic HIV Heroin Alports syndrome Sickle cell
Causes of rapidly progressive glomerulonephritis?
Goodpastures
Wegeners granulomatosis
SLE, microscopic polyarteritis
Treatment for peritoneal dialysis peritonitis?
Intraperitoneal vancomycin and ceftazidime
Treatment of cystinuria?
- Hydration
- Potassium citrate
- D penicillamine
Reduction of calcium renal stones?
Bendroflumathiazide
Reduction of uric acid stones?
Allopurinol
