Renal Flashcards
IgA nephropathy (berger)
post infections nephropathy
goodpastures
and vasculitis
are all exmaples of what
AGN
glomerular nephritis this is most commonly seen after Group A strep infection
post infectious
MCC of AGN worldwide
Berger’s IgA
what type of infections would we expect to led to berger’s dz
respiratory or GI
10 year old boy is seen with facial edema and dark cloudy urine 3 weeks following infection as well as oliguria
how would you dx him
most likely post infectious AGN
dx with antistreptolysin (ASO) titers and low serum complement c3
Tx is supportive
pt comes in 2 days following URI and is seen with hematuria, RBC casts and edema, as well as azotemia
what would be the official dx test
most likely IgA nephropathy given resent URI
dx with IgA mesangial deposits on immunostaining
this is a type of glomerulonephritis seen associated with anti-GBM antibodies that attack the basement membrane in the kidney and lung
how would you dx
good pastures
linear IgG deposits
what are the clinical manifestations of AGN
hematuria is the hallmark cola colored
edema in 85% due to decreased onctoic pressure and increase Na retention
HTN in 80% secondary to H20 retention
fever abdominal pain and flank pain due to renal capsule expansion
5. oliguria as a result of AKI
what is the nonspecific manner to dx AGN
UA with hematuria, RBC casts, dysmporphic RBC, proteinuria usually less than 3g, and a high specific gravity
elevated BUN and elevated Cr
renal biopsy is the gold standard but this is not needed in post strep as it is supportive tx
DVT and frothy urine are characteristic of this type of kidney injury
nephrotic syndrome
fatty casts and more than 3.5 g of protein
minimal change disease is a type of
nephrotic syndrome seen in children
what types of AKI are reversible
prerenal and postrenal
this is the most common type of AKI seen as a result of a decrease in renal perfusion
what is the tx
prerenal
nephrons are structurally intact and is usually corrected by volume repletion
BPH is a common cause of this type of AKI
post renal
what are the different types of intrinsic kidney injury we see
ATN
AIN
AGN
vascular
prolonged pre-renal hypotension, hypovolemia or post-op can result in what type of kidney injury
ischemica ATN
exogenous cause of nephrotoxic intrinsic AKI
AG (10-265), contrast dye, cyclosporin medications
endogenous causes of intrinsic ACT
Gout seen as cyrstal precipitation, myglobinuria (rhabdomylosis), lymphoma and leukemia, Bence-Jones multiple myeloma
MC type of intrinsic kidney dz
endogenous nephrotoxic
what would we suspect in a pt with epithelial muddy brown casts
ATN
what would we expect to see in the UA of a pt with ATN
low specific gravity b/c they are unable to concentrate urine do to tubular cell damage
muddy brown casts
wbc casts are paohtgonomic for
AIN
also seen with increase IgE
AIN is usually the result of
drug allergy 70%
PCN, NSAIDS, sulfa, cephalosporins, ciprofloxacin, rifampin, allopurinol.
15% due to infection
autoimmune 6%
idiopathic 8%
clinical manifestations of AIN
fever eosinophilia, maculopapular rash, arthralgia
remember this is hypersensitivity
