The kidney and systemic disease

Question 1

Name the leading cause of end stage renal failure

Answer 1

Diabetes melitus

Question 2

How can diabetes lead to end stage renal failure

Answer 2

Microvascular lesions associated with long duration or poorly controlled diabetes can give rise to:
1. diabetic retinopathy,
2. diabetic peripheral and autonomic neuropathy,
3. nephropathy

Question 3

Give examples of systemic disorders that can affect teh Kidneys

Answer 3

1. Diabetes
2. Microscopic vasculitis
3. Anti GBM disease
4. Amyloid
5. IgA nephropathy
6. Sarcoid
7. Systemic lupus erythmatosus
8. Systemic sclerosis

Question 4

What does systemic vasculitis describe

Answer 4

A variety of clinical syndromes that are characterised by inflammation and necrosis in the wall of blood vessels

Question 5

Give examples of systemic vasculitis disorders that can effect the kidneys

Answer 5

1. Wegeners granulomatosis
2. Microscopic polyarteritis
3. Polyarteritis nodosa

Question 6

What is anti GBM disease characterised by

Answer 6

The development of autoantibodies to GBM in the kidneys and lungs

Question 7

How do renal amyloid present

Answer 7

With proteinuria plus renal impairment

Question 8

What is IgA nephropathy

Answer 8

A glomerular disease characterised by deposition of IgA

Question 9

What is systemic lupus erythematosus

Answer 9

An autoimmune multisystem disease characterised by circulating autoantibodies against a number of cellular antigens

Question 10

What is systemic lupus erythematosus associated with

Answer 10

Nephritis

Question 11

Who is more common ti have systemic lupus erythematosus

Answer 11

women more than men
Black population more than Caucasians

Question 12

How does systemic lupus erythematosus present

Answer 12

1. Rash
2. Fatigue
3. Malaise
4. Muscle and join aches
5. Weight loss

Question 13

List the criteria that must be fulfilled before a diagnosis of systemic lupus erythematosus is made

Answer 13

4 or more of the following are required for a diagnosis:
1. Malar or butterfly facial rash
2. Discoid rash
3. Photosensitivity
4. Oral ulcers
5. Arthritis affecting two or more joints
6. Pleurisy or pericarditis
7. Renal abnormalities (persistent significant proteinuria, cellular
casts)
8. Haematological abnormalities
9. Immunological disorders

Question 14

What is systemic sclerosis also known as

Answer 14

Scleroderma

Question 15

What is systemic sclerosis

Answer 15

An autoimmune rheumatic disease characterised by fibrotic changes affecting skin and other organs

Question 16

How can systemic sclerosis present

Answer 16

With localised skin changes
or
wides-realign skin involvement, pulmonary fibrosis and renal involvement

Question 17

Name the most important renal complication of systemic sclerosis

Answer 17

Scleroderma renal crisis

Question 18

What is Scleroderma renal crisis

Answer 18

A life-threatening complication that present with:
1. Severe hypotension
2. hypertensive encephalopathy and seizures,
3. pulmonary oedema
4. acute renal failure.