RENAL - PKD, IN, Glomerulonephritis and Nephrotic/Nephritic syndrome Flashcards
What 3 ways can diabetes affect the kidneys
Direct glomerular damage
Ischaemia due to aa disease
Ascending infection
What is the most common cause of ballotable kidneys
PKD
PKD inheritance (2)
AD - PKD1 - 85%
AR - PKD2 - 15%
PS PKD (3)
HTN
CKD
Abdominal swelling b/c v large kidneys bilaterally
Where can cysts be found in PKD
Tubular epithelium - up to 4cm + brown
Also in liver –> portal HTN + fibrosis
What serious condition is PKD associated with
Berry aneurysm –> SAH
Mx PKD
Same as CKD
+ screen for berry aneurysms
From when does PKD start
Birth
What age does PKD usually present
From 30s
What are the 2 types of chronic interstitial nephritis
Reflux associated chronic interstitial nephritis
Obstructive chronic intersitial nephritis
What is Reflux associated chronic intersitial nephritis due to?
Incompetent VU valves
PS reflux associated chronic interstitial nephritis
Early adulthood
Deteriorating renal function
What is obstructifve chronic interstitial nephritis due to
Recurrent episodes of infection due to anatomical abnormality or a stone
What is glomerulonephritis
Inflammation of the glomerulus and can be a cause for both AKI and CKD
What are the 3 layers of the glomerulus
Fenestrated capillary epithelium
Basement membrane
Visceral layer - interdigitating podocytes
What are the 2 things causing damage to the glomerulus in glomerulonephritis
EIther autoantigens
Or immune complexes
Secondary factors –> auto-antigens (NSAID HSP)
NSAID HSP Neoplasm SLE Amyloid Infection Diabetes HSP
Damage to capillaries in glomerulonephritis (3)
Endothellial cell proliferation
Capillary wall necrosis
Glomerulosclerosis –> fenestra + capillaries being. pulled apart
Damage to basement mebrane in glomerlunephritis
Thickened membrane 00> structural distortion hence more permeable
Histology - global glomerulonephritis
Whole glomerulus is disease
Histology - segmental glomerulonephritis
Small patches of 1 glomerulus = damaged
Histology - diffuse glomerulonephritis
Affecting >50% glomeruli
Histology - focal glomerulonephritis
Affecting <50% glomeruli
How can glomerular disease manifest (6)
AKI CKD Asymp haematuria Nephrotic syndrome Nephritic syndrome Rapid progressive glomerulonephritis
What is nephrotic syndrome due to?
Increased permeability at the glomerulus (b/c inflammation and damage)
Triad - nephrotic syndrome (3)
Proteinuria >3days
Hypoalbuminaemia (<30g/L)
Oedema
Why does proteinuria occur in nephrotic syndrome
B/c increased glomerular permeability
Appearance urine nephrotic syndrome and why
Frothy
B.c mass proteinuria
Is nephrotic syndrome proliferative
No
What are the 3 most common 1’ causes of nephrotic syndrome (3)
Minimal change nephropathy
Membranoproliferative glomerulonephritis
Focal segment glomerulosclerosis
What is the most common cause of nephrotic syndrome in children
Minimal change nephropathy
What is the most common cause of nephrotic syndrome in adults
Focal segment glomerulosclerosis