Renal and Male GU pp1 Flashcards
Azotemia
biochemical manifestation of acute or chronic kidney injury; characterized by elevated blood urea nitrogen (BUN) or by an elevated serum creatinine; reflects a reduction in GFR
nephrotic syndrome
glomerular disease characterized by
1) severe proteinuria (more than 3.5g/day)
2) severe edema (periorbital)
3) hyperlipidemia
4) hypoalbuminemia
nephritic syndrome
glomerular disease characterized
1) grossly visible hematuria
2) azotemia with oliguria
3) HTN
4) sub-nephrotic proteinuria
most common/second most common cause of CRF/ESRD
1) Diabetes
2) HTN
prerenal azotemia
due to hypoperfusion of the kidneys
postrenal azotemia
seen when urine outflow is obstructed distal to the kidney, removal of obstruction corrects the azotemia
uremia
when azotemia becomes associated with a constellation of clinical signs and symptoms and biochemical abnormalities
rapidly progressive glomerulonephritis
characterized as a nephritic syndrome with a rapid decline in GFR (days to weeks). Implies severe glomerular injury
how does nephrotic syndrome cause edema?
decreased plasma oncotic pressure
How does DM contribute to glomerular pathologies?
persistent hyperglycemia causes glucotoxicity
normal GFR
90-120 ml/min
who has lower GFR?
older people; GFR decreases with age
acute kidney injury
1) rapid decline in GFR
2) more severe: oliguria or anuria
3) may be from glomerular, interstitial, vascular or acute tubular injury
4) reversible or can progress to CKD
How is mild chronic kidney disease seen clinically?
it can be clinically silent
How is severe chronic kidney disease seen clinically?
uremia
Definition chronic kidney disease
1) diminished GFR <60 ml/min/1.73m2 for at least 3 months
2) persistent albuminuria
Prognosis CKD
generally irreversible (requires dialysis)
end stage renal disease
- GFR <5% of normal
- end stage of uremia
fluid and electrolyte manifestations of uremia
dehydration
edema
hyperkalemia
metabolic acidosis
calcium phosphate and bone manifestations of uremia
hyperphosphatemia
hypocalcemia
secondary hyperparathyroidism
renal osteodystrophy
hematologic manifestations of uremia
anemia
bleeding diathesis
cardiopulmonary manifestations of uremia
HTN CHF cardiomyopathy pulmonary edema uremic pericarditis
gastrointestinal manifestations of uremia
nausea and vomiting
bleeding
esophagitis, gastritis, colitis
neuromuscular manifestations of uremia
myopathy
peripheral neuropathy
encephalopathy
dermatologic manifestations of uremia
sallow color
pruritus
dermatitis
glomerulus definition
vascular epithelial organ designed for the ultrafiltration of plasma
what does the macula densa produce
renin
erythropoetin
What happens with injury to podocytes?
proteinuria
Chronic glomerular responses to injury
1) basement membrane thickening
2) hyalinosis
3) sclerosis
What is seen with acute, severe glomerular injury?
crescents
diffuse glomerular disease
involves all glomeruli in kidney
focal glomerular disease
involves only a subset of glomeruli in kidney
segmental glomerular disease
of affected glomeruli, only portions are involved
global glomerular disease
involves the entire glomerulur
crescentic glomerulonephritis
- histo finding associated with RPGN
- collapsed, compacted glomerular tuft
- due to proliferating visceral and parietal epithelial cells
- infiltration of macrophages and leukocytes
HLA subtype associated with RPGN
HLA-DRB1
most common cause of nephrotic syndrome in children
primary kidney disease
Is a primary or secondary nephrotic syndrome more common in adults?
secondary
chronic glomerulonephritis
end stage glomerular disease fed by several streams of antecedent glomerulonephritis; a percentage of cases are idiopathic
