Renal Path Flashcards
What controlls blood flow into the bowmans capsule and how does NSAIDs change it (afferent)
controlled by PGE2 (vasodialater)
-NSAIDs reduce PGE2- lead to vasoconstriction of afferent arteriole and increased risk of ischemic damage to the medulla
What controlles effect of bowmans
Angiotensin type 2 (contractor)
Renal functions
Excrete harmful waste products maintain acid base homeostasis reabsorb essential substances Regulate water/sodium maintain vascular tone produce erythropoietin calcium homeostasis
Generalized signs of kidney pathology (+mc)
blood in urine (mc)*
- Abdominal swelling
- stroke
- fever
- itching
- thirst
- tiredness
- chest pain
- weight gain
Major clinical manifestations of renal diseases
Proteinura
Azotemia (elevation of Blood Urea nitrogen and createin levels as a result of decreased GFR)
What is pre renal azotemia and cause
cause: decreased cardiac
- patient loses ability to perfuse kidney structures-> leads to decreased GFR
*There will be no intrinsic renal parenchymal disease (will return to normal once cause is treated)
What is post renal azotemia + causes
Urinary tract obstruction below the kidney (prostate hyperplasia, ureter block, tumor)
-initially no renal parenchymal disease, but over time will (causes increased tubular pressure causes back diffusion of urea into the blood)
What is renal azotemia
Caused by parenchymal to kidney (acute tubular necrosis, chronic renal failure)
What are other minifistations of renal diseases other than proteunuria and azotemia
- Hematuria
- urinary mucrospoic changes
- hypertension
- electrolyte disorders
- casts
- oliguria/anuria/polyyria
What is renal agenesis
-Absence of one or both kidneys (bilateral deadly)
What is renal hypoplasia
- Usually unilateral
- presence of underdeveloped kidney unilat, other side is normall/fully developed kidney
What is horeshoe kidney and what is it associated with
- one of the mc kidney abnormalities
- kidney fusion of lower pole usually
- associated with turners syndorme
What is ectopic kidney/renal ectopia- and what can the symptoms mimic/what are you predisposed to
birth defect where kidney develops normally but is located below or above or contralateral of its usual pos
- symptoms may mimic urinary tract obstruction
- predisposed to pyleonephritis
What is a duplex kidney
they duplex kidney has a single renal parenchyma that is drained by 2 pyelocaalceal systems
What is autosmal recescive polycystic kidney- age, cause
dx in infnacy
-disorder is linked to an abnormal fibrocystic protein produced by the PKHD1 gene
Autosomal dominant polycystic kidney- age, caue
Autosomal dominant inheritance
-mc polycystic kidney disease 1 (PKD1) gene mutation
Clinical manisfitations of atosomal dominant kidney
Asymptomatic with norma; renal functins until middle age (delop slowly over time)
-hematuria, hypertension, abdominal mass (bilaterally) etc
What is renal dysplasia- etiology, pathophysiology
genetic
iatrogenic- mutation cased by ACE inhibitors and angiotension receptor blockers
- the tubules fail to branch out and urine has nowhere to go
- the urine collects inside the kidney and forms cysts
What is medullary sponge kidney kidney
Benign congenital disorder
-characterized by dialation of collecting tubules in 1 or more renal papillae affecting 1 or both kidneys
-usually asymptomatic (can rarely lead to chronic kidney disease/renal failure)
Wht is acuired cystic kidney disease and how do u get it
consequence of hemodialysis
3 stages of aquired cystic disease
- Tubue block- development of cysts is due to tubular abnormalities
- Compensatory growth- profound loss of renal tissue in endstage kidney disease promotes tubular cell hypertrophy and hyperplasia. Growth factors and activation of oncogenes
- Ishemia- kidney atrophy
What is simple retention cysts
Arise from glands by retention of their secreteion due to obstruction or obliteration of the ducts
-obstruction of the urinary duct can cause a kidney retention cyst
