Renal Physiology Flashcards
what is the associated cause to chronic renal failure?
diabetes
hypertension
vascular disorders
what is glomerulosclerosis
continuing damage to kidney function
what are the 2 main drivers of CKD?
Proteinuria
Angiotensin II
what does glomerular hyperfiltration lead to ?
increase in glomerular capillary permeability
increase in protein level in interstitial fluid
accumulating protein levels lead to tubulointestilital injury
what effect goes angiotensin II does to CKD
promotes glomerular hypertension
What are the CKD manifestations?
Azotemia
- decrease kidney function leads to a buildup of urea and creatinine
Uremia
pathological build-up of nitrogenous waste
what is uremic syndrome and what could it be the impact
an inflammatory state associated with high levels of nitrogenous compounds
lead to:
glucose tolerance
abnormal lipid metabolism
hyperparathyroidism
what is acute kidney injury
abrupt loss within 7 days of renal function
what cause AKD
ischaemia
drugs
hypotension
how can the AKD be classified as?
Prerenal
Intrarenal
posternal
what is prerenal AKI
reduced renal blood flow –> renal hypoperfusion
what is intrarenal AKI
a disorder involving the tissue of the kidney
could lead to acute tubular necrosis
what is postrenal AKI
blockages cause an increase in pressure within the kidney
Hypertension leads to a loss of filtrtion
What 3 phases does AKI have?
initiation phase
Oliguirc phase
repair phase
what can AKI lead to
metabolic acidosis
hyperkalaemia
uremia
How do we know if patient have AKI?
increase in serum creatinine b >0.3mg/dl within 48 hours
Increase in serium to >1.5times in 7 days
Urine volume < 0.5ml/kg/h for 6 hours
what is glomerulonephritis and what does it cause by?
is the damage to your tiny filters (the glomeruli)
its cause by immune system attacking its own body
what are the form of acute glomerulonephritis
Post-infective
Rapidly progessive
Goodpasture’s syndrome
sytemic auto-immune conditions (i.e. SLE - Systemic lupus erythematosus)
post-infective glomerulonoephritis
infaction with group A haemolytic strptococci
it is a deposition of complement and immune cell infiltration result in loss of kidney function
symptoms of Post-infective glomerulonephritis
oliguria - initial stage
haematuria
proteinuria
Oedema - due to sodium retention
what kind of stain can reveal the immune complex deposition in the capillaries
Anti-C3 antibody
streptococcus pyogenes
gram positive organism
could cause:
- strep throat
- scarlet fever
can produce toxin as well !!
Goodpasture’s syndrome
high aggressive form of glomerulonephritis
cause by antibodies like anti-GBM & form of IgG
HLA-DRB1 predisposition
nephrotic syndrome
cause by gross proteinuria
could also lead to hypoalbuminaemia
damage the glomerular membrane
IgA nephropathy is the cause of it
what is Berger’s disease
when IgA deposits builds up in the kidney, causing inflammation in the membrane and damage the kidney
oncogenes
mutated formas of normal genes which can drive to malignant change
tumour suppressor genes
inhibit cell growth and promotes apoptosis
DNA repair genes
fix any errors which may have occured in the genome
where can renal cancer arise from
adenomas (noncancerous tumors)
renal cells
renal pelvis
transitional cell carcinoma
Wilm tumour
most common kidney cancer in children
strongly associated with congenital abnormalities (WT1 gene)
what diagnosis can be used for wilm’s tumour?
renal biopsy
renal clear cell carcinoma
arise from proximal tubular epithlial cells –> high concentrations of epithelial cells
what kind of treatment is used in renal carcinoma?
surgery
targeted chemotherapeutic
cytokine infusion are used
–> inerleukin-2
what does nivolumab do?
prevents the binding of ligand and receptor
what does axitinib do?
small molecule tyrosine kinase inhibitor Binds to VEFGR 1-3. Prevents angiogenesis. Prevents vasculogenesis. May also promote autophagy.
