Renal Flashcards
Rapidly progressive GN (crescentic glomerulonephritis)
Nephritic (haematuria, hypertension)
Rapid onset
Often presents as AKI
Causes - Goodpastures, ANCA positive vasculitis (GPA…)
IgA nephropathy (Mesangioproliferative GN)
Nephritic (haematuria, hypertension)
Typically young adult with haematuria after URTI
Onset 1-2 days post-infection
Arthritis
= Henoch Schönlein Purpura
Thiazide diuretics
Block thiazide sensitive Na/Cl symporter -> inhibit sodium reabsorption at distal convoluted tubule
Potassium lost
Muddy brown casts
Condition?
Acute tubular necrosis
Post Streptococcal GN
Presentation
Findings
1-2 weeks after previous illness
Proteinuria/haematuria
Low complement
Tea/cola coloured urine
Positive antistreptococcal antibodies (ASO, ABO)
Minimal change disease
Features
Associations
Treatment
NEPHROTIC SYNDROME
Typically child
Normal renal function and histology
Ass: NSAIDs, Hodgkins
Short course prednisolone
Membranous GN
Presentation
NEPHROTIC SYNDROME
Most common adult GN
Immunosuppressive treatments -> can progress to ESRD
Needs multiple courses of steroids
Granular IgG complement deposition on GBM -> appears as spike and dome appearance with silver stain
Condition?
Membranous GN
Linear deposition of IgG on basement membrane and thickened basement membrane
Alport’s syndrome
Focal segmental glomerulosclerosis
Features
Histology
Nephrotic syndrome isn adults
Progresses to ESRD
Segmental scarring of some glomeruli with fusion of foot processes
Goodpasture’s Syndrome
Anti-GBM antibodies
Affects kidneys (RPGN) and lungs (alveolar haemorrhage ->haemoptysis)
Anti-phospholipid Syndrome
Antibodies
Features
Anti-cardiolipin
Arterial and venous thrombosis
Transient neurological deficit
Fetal loss
Thrombocytopaenia
Acute tubulointerstitial nephritis causes
Medications/toxins
RSVP
- rifampicin
- sulfa drugs
- V(5) Ps - PPI, pain killers (NSAIDs), pee pills, penicillins, phenytoin
Acute tubulointerstitial nephritis findings
Raised urea/creatinine
Raised eosinophils
Sub-nephrotic range protein
Microscopic haematuria
mechanism of renal injury with aciclovir
crystalluria
HLA renal transplant matching
DR
Nephrotic syndrome associated with hyper-coaguable state due to loss of …?
Antithrombin III deficiency
primary pulmonary hypertension
treatment
Prostacycline
Mechanism of injury of gentamicin (aminoglycosides)
Acute tubular necrosis
Type 2 tubular renal acidosis
findings (K, Ca, urine pH, stones)
low potassium
normal calcium
urine pH low
No renal stones
Type 2 tubular renal acidosis mechanism
Decreased HCO3+ resorption in proximal tubule
Type 2 tubular renal acidosis
associations
Fanconi syndrome
Wilson’s disease
Type 1 tubular renal acidosis
mechanism
Inability to excrete H+ into urine in distal tubule
Type 1 tubular renal acidosis
findings (K, Ca, urine pH, stones)
K low
Ca high
urine pH alkali
stones present
Type 1 tubular renal acidosis
Associations
Sjogrens, RA
Type 4 tubular renal acidosis
mechanism
Reduced aldosterone resulting proximal tubule ammonia excretion
Type 4 tubular renal acidosis
findings (K, Ca, urine pH, stones)
K high
Ca normal
Urine pH low
stones absent
Type 4 tubular renal acidosis
Associations
hypoaldosteronism
Diabetes
ADPKD
-> extra-renal manifestations
Liver cysts
Berry aneurysms
Mitral valve prolapse
Membranous GN
Associated antibody?
Anti-phospholipase A2
Goodpastures - which type of collagen is affected
Collagen type IV
Most common glomerulonephritis in SLE
Diffuse proliferative glomerulonephritis
Glomerulonephritis linked to cancer
Membranous glomerulonephritis
Diagnosing reflux nephropathy (in child)
Micturating cystography
Most common type of renal stone
Calcium oxalate
Treatment for calcium oxalate
- Calcium citrate - binds to oxalate in GI tract
Thiazide diuretics - decrease excretion of calcium
Renal stone type in renal tubular acidosis type 1
Calcium phosphate
Peritoneal dialysis infection -> most common organism
Staph epidermidis
