Renal Pathology Flashcards
Hydroureter
Accumulation of urine in the ureter
Hydronephrosis
Enlargement of the renal pelvis and calyces
ureterohydronephrosis
dilation of both the ureter and the pelvicaliceal system
Urinary tract obstruction can be cause by ___ or ____ defect
anatomical or functional
postobstructive diuresis
nephrogenic diabetes insipidus
kidney stones are classified according to the ___ that make up the stone
minerals
Kidney stones risk factors
sex and age
ethnicity
geographic location
seasonal factors
fluid intake
diet occupation
kidney stone formation
supersaturation of one or more salts
precipitation of a salt from liquid to solid state
growth into a stone via crystallization or aggregation
common kidney stone
calcium oxalate or calcium phosphate
struvite
uric acid
other factors affecting stone formation
crystal growth inhibiting substances
particle retention
matrix
evaluation of kidney stones
imaging studies
24 hr urinalysis
kidney stone removal
percutaneous nephrolithotomy
ureteroscopy
ultrasonic or laster lithotripsy
types of lower urinary tract obstruction
neurogenic bladder
- dyssynergia: detrusor hyper-reflexia vs detrusor areflexia
- overactive bladder syndrome
- obstruction: e.g. uretrhal stricture, prostate enlargement, pelvic organ prolapse
kidney cancers/tumours
renal tumours:
- renal adenoma
- renal cell carcinoma
Bladder tumours: renal transitional cell carcinoma
glomerulonephritis
Inflammation of the glomerulus
immunological abnormalities
ischemia
free radicals
medications or toxins
vascular disorders
infection
mechanisms of glomerulonephritis
- Deposition of circulation soluble antigen- antiboy complexes (Type III hypersensitivity)
- Antibodies reacting in situ against planted antigens within the glomerulurs (Type II hypersensitivity-cytotoxis)
- Nonimmune (ischemia, metabolic disorders, medications, toxins, vascular disorders, infection)
two major symptoms if severe glomerulonephritis
hematuria and RBC casts
proteinuria exceeding 3.5 g/day with albumin as the major protein
types of glomerulonephritis
membranous nephropathy/glomerulonephritis
rapidly progressing glomeurlonephritis (Goodpasture’s syndrome)
chronic glomeurlonephritis
Nephrotic Syndrome
excretion of 3.5 g or more of protein in the urine per day
caused by glomerular injury
Nephritic syndrome
hematuria with RBC casts
mildd proteinuria
immune injury
AKI can lead to
renal insufficiency
kidney failure
ESKD
oliguria pediatric vs adult
infants: < 1ml/kg/hr
children: <0.5ml/kg/hr
adults: < 400ml/day
prerenal cause of AKI
imparied renal blood flow
GFR declines b/f decrease in filtration pressure
both HTN And hypotension
intrarenal causes of AKI
acute tubular necrosis
postrenal cause of AKI
urinary tract obstructions that affect the kidneys bilaterally
three phases of AKI
initiation phase: prevention of injury is possible
maintenance (oliguric) phase: urine output is lowest, serum creatinine and blood urea nitrogen increases
recovery (polyuric) phase
AKI –> CKD
interstitial inflammation
endothelial dysfunction
fibrosis
tubular epithelial injury
CKD is divided in to __ stages based on albuminuria and/or renal function decline for a period longer than ____
5 stages
over 3 months
5 stages of CKD
normal (GFR > 90ml/min)
mild (GFR 60-89)
moderate (GFR 30-59)
Severe (GFR 15-29)
End stage (GFR < 15)
signs and symptoms of CKD
Proteinuria and uremia
Creatinine and urea clearance
Fluid and electrolyte imbalance
- metabolic acidosis
Reduced renal phosphate excretion, hypocalcemia-> fractures
Protein/carbohydrate/fat metabolism
Anemia
