The kidneys in systemic disease Flashcards
What is an immune complex
An antigen and an antibody joined together which can cause inflammatory reactions due to the antibody attached
What are the symptoms of nephrotic syndrome
Proteinuria, oedema, Hypoalbuminaemia and dyslipidaemia
What are the symptoms of nephritic state
Precipitates in the urine such as haematuria
Sometime proteinuria
High blood pressure
What is the leading cause of kidney failure
Diabetic nephropathy
How does diabetes lead to kidney failure
Diabetes causes hyperglycaemia and this causes changes to the kidney
The main cause is the weakened blood vessels in the glomerulus which causes the glomerular basement membrane to weaken and causes protein to be let through the glomerulus
What is the identifying feature of lupus
A butterfly rash that appears on the face
Who is most at risk of systemic lupus erythematosus
African, Carribean or asian descent at risk
What are the symptoms of lupus
Butterfly rash
Fever
fatigue
chest pain
achy joints
mouth ulcer
kidney disease
weight loss
ankle oedema
What is lupus nephritis
A form of immune mediated glomerulonephritis - it is proliferative type of GN and causes nephrotic syndrome and a nephritic state
What is key in the management of systemic lupus erythematous
Early treatment with immunosuppressive drugs or corticoid steroids
What is multiple myeloma
A monoclonal proliferation in plasma cells causing an excess of immunoglobulins and light chains
What is a myeloma
Type of blood cancer that develops from plasma cells
How does myeloma present
Marked elevated ESR
Anaemia
weight loss
fractures
infection
back pain
What does a high ESR mean (erythrocyte sedimentation rate)
That there is inflammation
How is myeloma diagnosed
Bone marrow aspirate > 10% clonal plasma cells
urinary bence-jones protein (BJP)
Lytic lesions
What are Bence-jones protein diagnostic of when over produced
Myeloma
What can cause a osteolytic lesion
Cancer building up in the bone marrow
What does myeloma do to the kidneys
Casts fill up the kidneys and block them (cast nephropathy)
Amyloidosis
Hyper-uricaemia - the myeloma generates too much urate which damages the kidney
Hypercalcaemia
What is amyloidosis
Amyloid fibril protein is deposited all around the body which causes a big systemic illness
What will urine dip show in multiple myeloma patients
heavy proteinuria
What symptoms should raise suspicion about systemic diseases involvement with a renal issue
Fever
Weight loss
Rash
Breathlessness
Haemoptysis
Oedema
Malaise
Arthralgia
Myalgia
epistaxis
Haematuria
What signs raise suspicion about systemic diseases involvement with a renal issue
Splinter haemorrhages
Purpura
Raynaud’s
vasculitic rash
scleritis, uveitis, retinal vasculitis
Hypertension, murmur
Crepitations, haemoptysis
stroke, encephalopathy
What is purpura
Occurs when little blood vessels under the skin bleed
What is Raynaud’s
Bad blood flow to the hands
