RENAL DISEASE Flashcards
CLASSIFICATION OF RENAL DISEASES
1.Glomerular Disorder
2.Tubular Disorder
3.Interstitial Disorder
Refers to sterile inflammatory processes that
affects the glomerulus and associated with the
finding of blood, protein and casts in urine
Glomerulonephritis
Sudden onset of symptoms with
consistent damage to the
glomerular membrane
Acute Poststreptococcal Glomerulonephritis
symptoms of Acute Poststreptococcal Glomerulonephritis
Fever
Hypertension
Edema
Oliguria
Fatigue
Hematuria
Acute Poststreptococcal Glomerulonephritis caused by:
- Streptococcus
pyogenes - Pneumonia
- endocarditis
- Severe infection
FINDINGS for Acute Poststreptococcal Glomerulonephritis
Hematuria
Proteinuria
Oliguria
Presence of casts (RBC cast, WBC casts, Hyaline Casts,
Granular Casts)
Increased BUN Levels
POSITIVE ASO Titer
Damage to capillary wall is due to macrophages that
will release cells and plasma in the Bowman’s space
Rapidly Progressive (Crescentic) Glomerulonephritis
Findings for Rapidly Progressive (Crescentic) Glomerulonephritis
- Similar to AGN
- Elevatted protein levels
- Very low GFR
Production of crescentic formations containing
macrophage, fibroblast and polymerized fibrin
Rapidly Progressive (Crescentic) Glomerulonephritis
Autoantibody attachment and complement activation
causes the damage to the capillaries.
Goodpasture Syndrome
urine findings for goodpasture syndrome
Macroscopic hematuria
Proteinuria
RBC casts
Due to the cytotoxic antibody (Antiglomerular Basement
membrane) found attached to the glomerular and
alveolar membranes during viral respiratory infection
Goodpasture Syndrome
Patient’s initial complaints when they have goodpasture sydrome
hemoptysis & dyspnea
Disorders affecting the systemic vascular system
resulting to the glomerular damage
Vasculitis
two types of Vasculitis
- Wegener’s Granulomatosis
- Henoch- Schönlein Purpura
It is considered as an immune complex disease and is
characterized by involvement of capillaries with diffuse
infiltration of neutrophils, lymphocytes and macrophages
Henoch- Schönlein Purpura
caused by antineutrophilic cytoplasmic antibody
(ANCA), which can be demonstrated in patient’s
serum for laboratory testing
Wegener’s Granulomatosis
Result of allergic vasculitis which involves the skin, GIT,
kidneys, heart and CNS
Henoch- Schönlein Purpura
causes granuloma producing inflammation of the
small blood vessels in the lungs and the kidneys
Wegener’s Granulomatosis
Patient’s serum IgA level is increased which may result
from mucosal infection
Immunoglobulin A Nephropathy/ Berger’s Disease
Thickening of the glomerular membrane due
to deposition of IgG immune complexes
Membranous Glomerulonephitis
DISORDERS ASSOCIATED with Membranous Glomerulonephitis
- Systemic Lupus Erythematosus
- Sjögren Syndrome
- Secondary syphillis
- Hepatitis B
- Gold & mercury treatment
- Malignancy
Nephrotic Syndrome occurs
Membranous Glomerulonephitis
Immune mediated disorder mostly affecting children characterized by
cellular proliferation in capillary walls or glomerular basement membrane
Membranoproliferative Glomerulonephitis
Increased cellularity in the subendothelial cells of the (mesangium)
interstitial area of the Bowman’s capsule, causing thickening of the
capillary walls
Type I
Extreme dense deposits in the glomerular membrane
Type II
Glomerular damage as a
result of renal disorder leads
to marked decreased in
renal functions and
eventually to renal failure
Chronic Glomerulonephritis
findings for Chronic Glomerulonephritis
hematuria
proteinuria
glucosuria
Cast ( broad cast)
Dec GFR
Inc BUN, Creatinine
level
Imbalance electrolytes
There is increase permeability of the glomerular
membrane due to disruption in the electrical charges
in the basal lamina and podocytes, producing a less
tightly connected barrier that allows massive loss of
protein and lipids
Nephrotic Syndrome
Primary Urinalysis Result for Nephrotic Syndrome
Heavy proteinuria
Microscopic hematuria
Renal tubular cells
Oval fat bodies
Fat droplets
Fatty and waxy casts
Podocytes appear to be
less tightly fitting allowing
increase infiltration of
protein
Minimal Change Disease (Lipid Nephrosis)
Urinalysis results for Minimal Change Disease (Lipid Nephrosis)
Heavy proteinuria
Transient hematuria
Fat droplets
The disease is caused by the disruption of
podocytes associated with analgesic and
heroin abuse and AIDS.
Focal Segmental Glomerulosclerosis
seen in the undamaged
glomerulus
IgM and C3
an inherited disorder affecting the glomerular basement
membrane
Alport Syndrome
increased proliferation of mesangial cells and increased
deposition of cellular and noncellular material within the
glomerular matrix resulting in accumulation of solid
substances around the capillary tufts
Diabetic Nephropathy
glomerular basement membrane has a lamellated
appearance with areas of thinning
Alport Syndrome
Diabetic Nephropathy also known as
Kimmelstiel-Wilson disease
currently the most common cause of end-stage renal
disease.
Diabetic Nephropathy
primary disorder associated with damage to the
renal tubules
Acute Tubular Necrosis
disorder most frequently associated with tubular
dysfunction
Fanconi’s Syndrome (Hereditary)
Associated with exposure to toxic agents
Acquired
2 types of Hereditary and Metabolic Disorder
- Fanconi’s Syndrome
- Acquired
Disorders affecting the renal interstitium which
also affects the tubules
INTERSTITIAL DISORDER (tubulointerstitial disease)
Ascending bacterial
infection of the bladder
Cystitis
Infection of the renal
tubules and interstitium
related to interference of
urine flow to the bladder,
reflux of urine from the
bladder, and untreated
cystiti
Acute
pyelonephritis
urinary result of Acute
pyelonephritis
Hematuria
Proteinuria
Leukocyturia
WBC casts
urinary result of Chronic
pyelonephritis
- Leukocyturia
- Bacteriuria
- WBC casts
- Bacterial casts
- Granular, waxy, broad casts
- Hematuria
- Proteinuria
Decreased glomerular
filtration rate
Chronic Renal Failure
Acute Renal Failure
Prerenal causes:
Burns
Hemorrhage
Surgery
Acute Renal Failure
Renal Causes:
Acute
glomerulonephritis
Acute
pyelonephritis
Acute tubular
necrosis
Acute Renal Failure
Post Renal Causes:
Tumors
Calculi
Crystallization of
ingested
substancces
GENERAL CHARACTERISTICS OF ACUTE
RENAL FAILURE
*Decrease in GFR
*Oliguria
*Edema
*azotemia
Deposition of renal calculi or
kidney stones in the calyces and
pelvis of the kidney, ureters and
urinary bladder
RENAL LITHIASIS
- a procedure using high-energyshock waves, to break stones
located in the upper urinary tract into the pieces that can be then passed in
the urine
lithiotripsy
CONDITIONS FAVORING STONE
FOMATION
pH
Chemical concentration
Urinary stasis
Cystine
