Renal Parenchymal disease

Question 1

how does atheroembolic renal disease tend to manifest

Answer 1

AKI w/ patient who has erosive atherosclerosis, typically after aortic manipulation

livedo reticularis (lacey rashes on legs), hollenhorst plaques (retinal finding), cyanosis

low grade fever, nephritic sediment, eosinophilia, low C3- these emboli are very immunogenic

Question 2

appropriate use of FENa in AKI

Answer 2

distinguish b/w pre renal azotemia from ATN when patients have acute oliguric kidney dysfn

more reliable w/o prior kidney dysfn or diuretic use (CKD can still have high FENa even w/ prerenal)

Question 3

when to use FEurea

Answer 3

if on diuretics, over 50% indicates likely ATN

Question 4

myoglobin effect on renal parenchyma

Answer 4

pigment nephropathy- a kind of nephrotoxic ATN, can see myoglobin casts and staining for myoglobin in tubules

Question 5

tumor lysis syndrome effect on kidneys

Answer 5

release of uric acid causes precipitation in tubules, calcium phosphate deposits in tubules as well

rhomboid uric acid crystals can be seen in urine