Renal diseases Flashcards
What are the 4 main functions of the kidneys?
- eliminating metabolic waste products
- regulating fluid and electrolyte balance
- influencing acid-base balance
- production of some hormones
How would a patient with acute renal failure present?
- rapid rise in creatinine and urea
- generally unwell
How would a patient with nephrotic syndrome present?
- oedema + proteinuria + hypoalbuminaemia
- proteinuria >3g per 24 hrs
How would a patient with acute nephritis present?
-oedema, proteinuria, haematuria, renal failure
How would a patient with chronic renal failure present?
-slowly declining renal function
What toxic mechanisms can cause tubular damage to the kidneys?
- direct toxins
- hypersensitivity reactions
- deposition of crystals in tubules
- deposition of abnormal proteins in tubules
What is nephrotic syndrome ALWAYS due to?
damage to the glomerulus
What complications can you get with nephrotic syndrome?
infection and thrombosis
What are the 4 common causes of acute nephritis in adults?
- post-infective glomerulonephritis
- IgA nephropathy
- vasculitis
- lupus
What are the 4 common causes of acute nephritis in children?
- post-infective glomerulonephritis
- IgA nephropathy
- Henoch-Schonlein purpura
- haemolytic-uraemic syndrome
What are the 3 main groups of causes of acute renal failure?
- pre-renal (reduced blood flow to kidneys)
- renal (damage to kidney)
- post-renal (obstructed urinary tract)
What are the major complications of acute renal failure?
- cardiac failure (fluid overload)
- arrhythmias (electrolyte imbalance)
- GI bleeding
- jaundice
- infection
How is chronic renal failure characterised?
permanently reduced GFR (reduced number of nephrons)
What are the common causes of chronic renal failure in adults?
- diabetes
- glomerunephritis
- reflux nephropathy
What are the common causes of chronic renal failure in children?
- developmental abnormalities
- reflux nephropathy
- glomerulonephritis
What could cause urinary tract obstruction at the level of the pelvis?
- calculi
- tumours
- ureteropelvic structure
What can cause intrinsic uteric obstruction?
- calculi
- tumours
- clots
- sloughed papillae
- inflammation
What can cause extrinsic uteric obstruction?
- pregnancy
- tumour
- retroperitoneal fibrosis
What would you see in a kidney with hydronephrosis?
- dilated calyces
- dilated pelvis
- cortical atrophy
where are renal calculi most commonly formed?
in the kidney (can be anywhere in the urinary tract though)
What are the 4 commonest causes of calium stones?
- hypercalcaemia
- excessive absorption of intestinal Ca+
- inability to reabsorb tubular Ca+
- idiopathic
How to struvite stones form?
- urea convers urea to ammonia
- causes a rise in urine pH
- precipitation of magnesium ammonium phosphate salts
- larger ‘staghorn’ calculi
What is Von Hippel-Lindau Syndrome?
most common of several cancer syndrome in kidneys
-VHL gene required fro breakdown of hypoxia inducible factor-1 oncogene
What is the morphology of clear cell RCC?
- well defined yellow tumours
- often haemorrhagic areas
- may extend into perinephric fat or into renal vein
