Renal Pathology Flashcards
What 2 major hormones does the kidney produce?
- EPO
- Renin
How is serum creatinine and urea affected in acute renal failure?
Rapid rise in serum creatinine and urea
How is urine output affected during AKI?
Anuria/oliguria
What are the general symptoms of AKI?
Malaise, fatigue, nausea, vomiting, arrhythmias
In which 3 locations can the cause of AKI occur?
- Pre-renal
- Renal
- Post-renal
What is pre-renal AKI most commonly due to?
Reduced blood flow to kidneys (hypoperfusion):
- Severe dehydration
- Hypotension (bleed, septic shock, LVF)
What is renal AKI most commonly caused by?
Damage to kidney itself (often vasculitis)
What is post-renal AKI most commonly caused by?
Urinary tract obstruction:
- Urinary tract tumours
- Pelvic tumour
- Calculi
- Prostatic enlargement
Prognosis of AKI?
Prognosis usually good if no underlying renal disease (short term dialysis may be needed in some patients)
How can AKI lead to;
a) arrhythmias?
b) cardiac failure?
c) jaundice?
a) fluid overload
b) electrolyte imbalance
c) hepatic venous congestion
What is nephrotic syndrome?
A collection of symptoms due to kidney damage, causes your body to pass too much protein in your urine.
What is nephrotic syndrome always due to?
Damage to glomerulus
What is the commonest cause of nephrotic syndrome in adults?
Membranous nephropathy
What is membranous nephropathy?
A disorder where the body’s immune system attacks the filtering membranes in the kidney.
What are the 4 major causes of nephrotic syndrome?
- Membranous nephropathy (commonest)
- Focal segmental glomerulosclerosis (FSGS)
- Minimal change disease
- Other; diabetes, lupus nephritis, amyloid
What is FSGS?
Focal Segmental glomerulosclerosis is a type of glomerular disease and describes sclerosis in your kidney. The scarring of FSGS only takes place in small sections of each glomerulus.
What is minimal change disease?
Damage to glomeruli
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
Where does minimal change disease get its name?
Normal histology
What is the 1 other major cause of nephrotic syndrome in children?
FSGS
What are the signs & symptoms of nephrotic syndrome?
- Proteinuria; foamy urine
- Oedema (particularly in feet and ankles)
- Hypoalbuminaemia (due to proteinuria)
- +/- hypertension
- +/- hyperlipidaemia
- BUT no sign of renal failure
What is the cause of oedema in nephrotic syndrome?
Due to low albumin levels –> reduction in oncotic pressure and an increase in filtration across the capillary, resulting in excess fluid buildup in the tissues (oedema).
What is acute nephritis (nephritic syndrome)?
Inflammation of kidneys
What does acute nephritis typically follow?
Can be after severe infection e.g. strep throat, hepatitis, HIV
Signs of acute nephritis?
- Oedema
- Proteinuria
- Haematuria
- Hypertension
- Renal failure
What are 4 major cause of acute nephritis in adults?
- Post-infective glomerulonephritis
- IgA nephropathy
- Vasculitis
- SLE
What does post-infective glomerulonephritis follow?
Streptococcal infection
What is IgA nephropathy?
A kidney disease that occurs when IgA deposits build up in the kidneys, causing inflammation that damages kidney tissues.
What is IgA nephropathy also known as?
Berger’s disease
Prognosis of IgA nephropathy?
20-50% renal failure over 20 years
What are 4 major causes of acute nephritis in children?
- Post-infective glomerulonephritis
- IgA nephropathy
- Henoch-Schönlein purpura
- Haemolytic-uraemic syndrome