Renal Disease Flashcards
There are the 4 types of renal disease, what is a disease of the glomerula?
- disease that affects the filtration capabilities of the kidney
There are the 4 types of renal disease, what is a tubulointerstitial compartment?
- disease affecting the tubules directly or the interstital space
There are the 4 types of renal disease, what is arcuate blood vessels within the kidneys disease?
- disease affecting the arcuate blood vessels
- arc like blood vessels run around the medulla
There are the 4 types of renal disease, what are congenital diseases of kidneys?
- inherited kidney disease
if acute kidney disease always cause chronic kidney disease if left untreated?
- yes
What is the most serious cause of acute kidney disease?
- acute glomerulonephritis (acute nephritis)
- inflammation of glomerulus
Acute thrombotic microangiopathy is a cause of acute kidney disease, what is it?
- condition where thrombosis in capillaries and arterioles of kidneys is present
- can occlude the blood vessels
Tubulointerstitial nephritis is an acute kidney disease, what is it?
ubulointerstitial nephritis is inflammation that affects the tubules of the kidneys and the tissues that surround them (interstitial tissue).
What is the most common cause of chronic kidney disease?
- diabetes
Hypertensive glomerulopathy is the second most common cause of chronic kidney disease, what is it?
- kidney f disease attributed to a history of hypertension
What are the 2 main things that are not filtered by the golerulus?
1 - lipid bound drugs
2 - proteins
What is ultrafiltrate?
- what has been filtered in the glomerula
Ultrafiltrate is what has been filtered in the glomerula. Once filtered where does the ultrafiltrate go?
- enters the bowmans capsule (empty space)
then enters the proximal conveluted tubule
The image below is a cross section of a glomerula. What do each of the acronyms in the image below denote?
- JGA
- MD
- GBM
- EPI
- E
- BS
- EA
- AA
- JGA = Juxta glomerular apparatus
- MD = Macula densa
- GBM = Glomerular basement membrane
- EPI = Epithelial cell
- E = Endothelial cell
- BS = Bowman Space
- EA = Efferent Arteriole
- AA = Afferent Arteriole
What is the main role of macula densa cells in the proximal conveluted tubules?
- provides tubulur feedback on Na+ levels
The macula densa cells in the proximal conveluted tubules provides tubulur feedback on Na+ levels. If the Na+ levels drop, what 2 roles can macula densa cells perform?
- dilate afferent and constrict efferent arterioles
- signal to the juxtaglomerular cells to secrete renin
What is the histology image of below?
- normal glomerula with surrounding tubules
What does the location of immune deposits in the glomerula tell us?
- potential histopathological diagnosis
The image below denotes the different layers of the glomerula, with the acronyms as follows.
GBM: Glomerular Basement Membrane
EN: Endothelial cells
EP: Epithelial cells
MC: Mesangial cells
MM: Mesangial matrix
The location of where immune deposits can be found are numbered 1-5. What do the numbers 1-5 denote?
- 1 and 2 = Sub epithelial
- 3 = Sub endothelial
- 4 = Mesangial
- 5 = Deposits within glomerular basement membrane
If the podocytes are damaged in the glomerula, what happens to the filtration?
- podocytes normally only allow small positively charged ions to pass
- if damaged positive and negative charged ions can diffuse
If normal podocytes large and negative molecules are unable to pass the podocytes and are therefore not filtered. What is a large negatively charged molecules in the blood that does not not normally get filtered, but if the podocytes are damaged may be able to?
- proteins
Does a high protein in your urine affect urine volume?
- no
- does not affect urine osmolarity
In urine microscopy, what is the most important cast?
- RBC casts
- indicate glomerula disease
- bleeding of the glomerula
What is nephritic syndrome?
- clinical name given to a collection of different signs and symptoms
- these occur as a result of inflammation in the kidneys
What is nephrotic syndrome?
- clinical term to describe large amounts of protein that leak into the urine
- symprtoms include swelling of body tissues and a greater chance of catching infections
Nephritic syndrome is a clinical name given to a collection of different signs and symptoms that can occur as a result of inflammation in the kidneys. What common features are present with nephritic syndrome?
- heamaturia (RBC casts)
- patients have hypertension
- acute kidney injury
- oliguria (less than 400 ml per day)
- proteinuria (usually < 3.5 g/day)
Nephrotic syndrome is a clinical to describe large amounts of protein that leak into the urine, causing symptoms including swelling of body tissues and a greater chance of catching infections. What other clinical features will they have?
- severe Proteinuria (>3.5g/day)
- serum hypoalbuminemia (<30 g/L)
- generalised oedema
- hyperlipidaemia (protein leak causing increased lipoprotein production)
- increased risk of venous thromboembolism (loss of anticoagulants)
There are autoimmune diseases that can cause kidney disease. Are there any type 1 hypersensitivity causes of kidney disease?
- IgE response
- no known renal disease
There are autoimmune diseases that can cause kidney disease. Type 2 hypersensitivity, which is cytoxic hypersensitivity. Here IgG and IgM antibodies bind to host tissue and identify it for programmed cell death by the complement system, antibody-dependent cell-mediated cytotoxicity (ADCC) where natural killer cells destroy host cells and opspnisation. What renal disease can this cause?
- membranous glomerulonephritis
- Anti GBM disease
- ANCA associated glomerulonephritis/polyangitis
- antibody mediated graft rejection
There are autoimmune diseases that can cause kidney disease. Type 3 hypersensitivity, which is where there are mutliple antibodies bound to an antigen, but the immune cells cannot degrade them. They can then collect in different parts of the body where immune cells can aggregate in an attempt to destroy them. What renal disease can this cause?
- antibody-antigen complexes collect in the glomerulus causing damage
- lupus nephritis
- post-infectious glomerulonephritis
- hepatitis B,C associated glomerulonephritis
- cryoglobulinemic glomerulonephritis
There are autoimmune diseases that can cause kidney disease. Type 4 hypersensitivity, which is T cell mediated macrophage and inflammation. CD8+ T cell mediated direct cell cytotoxicity. What renal disease can this cause?
- sarcoidosis
- systemic sclerosis related tubulointerstitial nephritis
- acute graft rejection
There are 2 main groups of glomerula disease, what are these groups?
1 - primary glomerular disease
2 - systemic disease causing a secondary glomerular injury
There are 2 main groups of glomerula disease, primary glomerular disease and systemic disease causing a secondary glomerular injury. What are the 2 most important diseases?
- minimal change disease
- primary membranous glomerulonephritis
There are 2 main groups of glomerula disease, primary glomerular disease and systemic disease causing a secondary glomerular injury. 2 important primary diseases are minimal change disease and primary membranous glomerulonephritis. What is minimal change disease?
- large amounts of protein is lost in the urine
- one of the most common causes of the nephrotic syndrome worldwide.