Renal Disease and Its Investigation Flashcards
The Urinary system consists of (4)
Bladder
Urethra
Kidneys
Excretory duct system
Upper urinary tract consists of:
Lower urinary tract consists of:
Kidneys
Ureters, Urethra, Bladder
Kidney functions (4)
Excretion of nitrogenous waste products Reabsorption of important molecules Maintenance of water, electrolyte and pH balance Hormone production (renin, erythroproietin)
Functional unit of the kidney is the..
Each kidney contains how many of these
Nephron
1 million
Function and major components of nephrons: Renal Corpuscle Tubular system Coleciting duct Vasculature
Filtration
Reabsoprtion & secretion
Reabsorption of water under ADH control
oxygenates tubules, reuptake of glucose
4 main components of glomerulus and function
endothelial cells line capillaries
Glomerular basement membrane performs filtration
podocytes are specialised epithelial cells
mesangium: Supporting cells and matrix
Patterns of renal Disease: Global: Segmental: Diffuse: Focal:
Affects whole of glomerulus uniformly
Affecting one glomerular segment, leaving others unaffected
Affecting all glomeruli in both kidneys
Affecting a portion of glomeruli, leaving others unaffected.
Glomerulonephritis
Inflammation of the glomerulus
Haematuria
Blood in the urine
Hypoabluminaemia
abnormally low levels of albumin in blood
Oliguria
Low levels of urine output 300-500ml per day
Uraemia
High levels of nitrogenous compounds in urine
Nephrotic syndrome
Nephritic syndrome
signs associated with inflammation in kidney
nonspecific disorder where kidneys are damaged
Acute renal failure properties (5)
nephrons tend to cease working suddenly oliguria, anuria, acidosis, uraemia caused mainly by glomeruloneprhitis often reversible if damaging stimulus removed necrosis precludes regeneration
Chronic renal failure properties: (4) potential causes (3)
progressive nephron destruction over time
progressive loss of renal function
less metabolic disturbance than with total renal failure
uraemia, polyuria, biochemical changes
vascular disease
diabetes
glomeruloneprhitis
chronic renal failure not reversible due to
nephron destruction
Nephrotic syndromes:
usually a result in changes of — or —
loss of selective retention of — in the —
Usually leads to —
This loss of — leads to —
glomerulus basement membrane mesangial cells proteins blood proteinuria protiens oedema
Nephritic syndrome characterised by —- changes in the cells outside the —-
proliferative
glomerulus
Nephrotic syndrome signs (5)
weight gain foamy urine fatigue oedema loss of appetite
4 symptoms of nephrotic syndrome
Proteinuria
Hyperlipidemia
Hypoabluminaemia
Oedema
Minimal change disease: most common in EM shows loss of appearence of --- is observed and ----- of podocytes Permeability of GBM is --- treatment involves
Young Children Podocyte feet microvilli vacuolation increases immunosuppressants
Focal Segmental Glomerulosclerosis:
Characterised by —-
scarring of glomerulus
Membranous Nephropathy: Characterised by presence of --- in --- Deposits are in all segments of all glomeruli so which 2 patterns of renal disease does this fall under? mainly seen in --- as a main cause of caused by ---- forming in glomerulus
Immune complex deposits glomerulus Global & Diffuse Adults nephrotic syndrome Immune complexes
3 pathological stages of membranous nephropathy:
This causes what to happen to GBM
sub-epithelial immune complex deposition in GBM
New basement membrane deposited around immune complexes
when immune complexes clear, it leaves a thickened, lacy basement membrane
GBM becomes abnormally permeable
Membranous neprhopathy causes: 3
infection
drug related
tumour associated
5 main patterns of response of glomerulus to damage
Endothelial cell proliferation mesangial cell proliferation GBM thickening capillary wall necrosis crescent formation
Diagnosis and clinical management of renal disease often largely through
biochemistry
urgent biopsy needed to achieve (3)
diagnose or rule out
ascertain severity of legion
ascdrtain amount of irreversible scarring
Taking the biopsy for renal disease involves a true cut — or a spring loaded –/–. local anaesthetic guided by —
biopsy taken under dissecting microscope to ensure presence of — and —-
needle biopsy gun ultrasound glomerulus renal cortex
Structural change in GBM or extensive mesangial deposition comes under
nephrotic syndrome
Glmoerular change due to proliferation of endothelial or mesangial cells comes under
Nephritic syndrome
