Renal diseases Flashcards
What is erythropoietin, and how is it related to anemia in chronic kidney disease?
Erythropoietin is a glycoprotein produced by kidney fibroblasts that stimulates red blood cell production in the bone marrow. In chronic kidney disease, decreased erythropoietin production leads to anemia due to reduced red blood cell formation.
What tests are used to assess renal function?
Blood tests (urea, phosphate, creatinine) and urine analysis (proteinuria, hematuria). Imaging techniques (US, CT, MRI) assess structure and obstructions. Creatinine clearance and eGFR estimate glomerular filtration rate.
What is glomerulonephritis?
It is inflammation of the glomeruli leading to impaired kidney function and renal failure.
What are the etiologies of glomerulonephritis?
Causes include autoimmune diseases (SLE), infections, IgA nephropathy, and genetic disorders
Most cases of primary and many cases of secondary glomerular disease probably have an immune origin
Explain the pathophysiology of glomerulonephritis.
Autoimmune or inflammatory processes damage glomerular capillaries, leading to reduced filtration efficiency, hematuria, proteinuria, and reduced GFR. Changes include proliferation, membranous thickening, and sclerosis.
What are two types of immune mechanisms that have been implicated in the development of glomerular disease
- Injury resulting from antibodies reacting with (fixed) glomerular antigens (or antigens planted within the glomerulus)
- Injury resulting from circulating antigen–antibody complexes that become trapped in the glomerular membrane
What are the clinical manifestations of glomerulonephritis?
Symptoms include hematuria, proteinuria, edema, hypertension, fatigue, and reduced urine output.
What kind of cellular changes occur with glomerular disease?
It increases in glomerular or inflammatory cell number (proliferative or hypercellular), (basement) membrane thickening (membranous), and changes in noncellular glomerular components (sclerosis and fibrosis).
Define nephrotic syndrome.
A condition characterized by proteinuria (>3.5 g/day), hypoalbuminemia, edema, hyperlipidemia, and lipiduria.
What is the pathophysiology of nephrotic syndrome?
Increased glomerular permeability causes protein loss, hypoalbuminemia, and edema. Hyperlipidemia occurs due to compensatory lipid synthesis.
List clinical manifestations of nephrotic syndrome.
Massive proteinuria, hypoalbuminemia, generalized edema, hyperlipidemia, dyspnea, and increased infection risk.
What is chronic kidney disease (CKD)?
Chronic kidney disease (CKD) is a progressive decline in kidney function because of the permanent loss of nephrons. CKD is defined as either kidney damage or a low glomerular filtration rate GFR
Progressive loss of kidney function over >3 months, often leading to end-stage renal failure.
What causes CKD?
Main causes are Hypertension and diabetic kidney disease.
Describe the pathophysiology of CKD.
Gradual nephron loss leads to compensatory hypertrophy of remaining nephrons, eventually resulting in irreversible damage, waste buildup, and fluid imbalance.
What are the symptoms of CKD?
Early stages are asymptomatic. Later stages show anemia, uremia, hypertension, fluid retention, bone disease, and cardiovascular issues.
What is Polycystic Kidney Disease (PKD)
A genetic disorder causing fluid-filled cysts in kidneys, leading to enlarged kidneys and impaired function.
Differentiate between ADPKD and ARPKD.
ADPKD appears in adulthood (mutations in PKD1/PKD2); ARPKD appears in childhood (mutations in PKHD1).
What are the clinical manifestations of PKD?
Hypertension, flank pain, hematuria, kidney stones, infections, and progressive renal failure.
What is hydronephrosis?
Kidney swelling due to urine buildup from obstruction, causing renal damage.
What are the symptoms of hydronephrosis?
Pain, reduced urine output, infections, hypertension, and kidney failure.
What causes urinary obstruction?
Kidney stones, tumors, enlarged prostate, pregnancy, and strictures.
What are the clinical effects of urinary obstruction?
Urine stasis, infections, stone formation, hydronephrosis, and renal failure.
What are kidney stones?
Aggregates of minerals and crystals forming in the urinary tract.
What causes kidney stones?
High concentrations of stone-forming substances, low inhibitors of crystallization, and urine stasis.
What are the symptoms of kidney stones?
Renal colic (severe pain), nausea, vomiting, hematuria, and non-colicky dull pain.
What is dialysis?
A treatment for renal failure that removes waste and excess fluid when kidneys can’t function properly.
Describe the types of dialysis.
Hemodialysis (blood filtered outside the body) and peritoneal dialysis (fluid exchange through the abdomen).
What are common bladder and urethral disorders?
Obstructions, urinary stasis, incontinence, and cancers.
What causes urinary incontinence?
Weak pelvic muscles, nerve damage, bladder overactivity, or obstruction.
What are symptoms of bladder cancer?
Hematuria, frequent urination, and pelvic pain.
What causes urinary and kidney infections?
Bacteria (E. coli most common), urinary stasis, catheter use, or obstructions.
What are the symptoms of infections in the kidney?
Dysuria, urgency, frequency, fever, flank pain, and cloudy or foul-smelling urine.
Define nephritic syndrome.
A condition characterized by hematuria, oliguria, hypertension, and mild proteinuria (<3.5 g/day).
What is the pathophysiology of nephritic syndrome?
Inflammation and damage to the glomerular capillary walls result in reduced filtration, leading to hematuria, oliguria, and fluid retention.
List clinical manifestations of nephritic syndrome.
Hematuria (cola-colored urine), oliguria, hypertension, edema, mild proteinuria, and azotemia.
How do nephrotic and nephritic syndromes differ?
Nephrotic Syndrome: High proteinuria (>3.5 g/day), hypoalbuminemia, generalized edema, hyperlipidemia, lipiduria, and increased thrombotic risk.
Nephritic Syndrome: Hematuria, oliguria, hypertension, mild proteinuria (<3.5 g/day), edema, and azotemia.
