renal vascular problems Flashcards
Renal artery stenosis what causes manifestation diagnostic sudies
partial occlusion of one or both renal arteries and major branches
Casues: atherosclerosis or fibromuscular hyperplasia
Manifestations: sudden HTN (usually under 30 or over 50 yrs old)
Studies: renal duplex Doppler ultrasound, CT or MRI angiography, and renal arteriogram
Renal artery stenosis
treatment goals
treatments
Goals:
-control BP and restore renal perfusion
Treatments:
percutaneous transluminal renal angioplasty
surgical revascularization
-nephrectomy (if one kidney involved)
Renal vein thrombosis
can be unilateral or bilateral
causes: trauma, extrinsic compression, renal cell cancer, pregnancy, contraceptive use, and nephrotic syndrome
manifestations: flank pain, hematuria, or nephrotic syndrome
Treatments
- anticoagulation
- corticosteroids
- surgical thrombectomy
Hereditary kidney diseasee
Developmental abnormalities of renal parenchyma
- cystic in nature
- rule out other causes and tumors
Nephrosclerosis
benign
accelerated
treatment
Sclerosis of arteries in kidney causes less blood flow, ischemia, interstitial fibrosis, and necrosis
benign = age related (over 60) changes due to HTN and atherosclerosis
accelerated (malignant) = medical emergency de to severe HTN –> SBP over 180 and/or DBP over 120
Treatment = andihypertensive drugs
Polycytic kidney disease (PKD)
what
types
Common and life threatening
- 600,000 in US
- 4th leading cause of ESRD
Genetic link: 2 hereditary forms
- adult = autosomal dominant (90% of cases)
- child - autosomal recessive
Adult PKD
Affects both kidneys in men and women
cortex and medulla fill with thin walled cysts that destroy surrounding tissue by compression
cysts are full of fluid –> can have blood or pus
signs and sympts dvlp at 30-40 yrs old
Manifests: HTN, hematuria, pain or heavy feeling in back/side/abdomen; UTI or urinary stone; may be asymptomatic —> chronic severe pain is most common
kidneys ar big and maybe palpable
Adult PKD
studies
treatment
nursing
Studies: ultrasound or CT scan (also fam history)
Treatment: no cure
- prevent or treat UTI
- nephrectomy
- dialysis and kidney transplant
Nursing: management for ESRD; genetic counseling
Medullary cystic disease NOPE
Hereditary disorder of older adults
kidneys with cysts in medulla are asymmetric and scarred –> can’t concentrate urine
manifest: polyuria, HTN, progressive renal failure, severe anemia, metabolic acidosis
Treatment; as with ESRD
-genetic counseling
Alport syndrome NOPE
Chronic hereditary nephritis
- males earlier and more severe than females
- gene mutation for collagen resulting in altered synthesis of glomerular basement membrane
3 types
- sex linked (most common) = hematuria, hearing loss, deformities in lens
- autosomal recessive = hematuria
- autosomal dominant = hematuria
Treatment: management of ESRD is kidney transplant
