Tubulo-interstitial diseases Flashcards
what kind of cells in tubules?
specialized cuboidal, metabolically active, microvilli
what is interstitium?
CT where glomeruli,tubules and vessels lie
is there much interstitium normally?
normally not, just think layer, more if disease like oedema/fibrosis
what normally causes acute tubular necrosis? 3 things
ischaemic injury of tubular epithelial cells
acute pyelonephritis
Acute/Chronic tubulointerstitial nephritis
What is most common cause of acute renal failure?
acute tubular necrosis
when do tubular epithelial cells suffer in acute tubular necrosis?
they are first to die, degenerate, detach and slough off
is acute tubular necrosis reversible?
yes if caught early, put on dialysis for a few weeks and the tubular epithelial cells regenerate
recovery of acute tubular necrosis associated with?
diuresis
what’s the difference between hypoperfusion and ischaemic ATN?
hypoperfusion is decrease GFR, it’s not enough to kill any epithelial tubular cells
what is toxic acute tubular necrosis? causes? mechanism?
heavy metals
antibiotics
chemo
disrupt mitochondrial function
Acute interstitial nephritis usually due to?
drug alllergy
Acute interstitial nephritis presentation histologically?
tubules and interstitium infiltrated with eosinophils/inflammatory cells
Pyelonephritis caused by what kind of Bacteria?
ascending gram negatives usually
Pyelonephritis acute or chronic?
can be both
Pyelonephritis obstruct urine?
yes or no
acute Pyelonephritis presentation?
rigors, severe acute onset, frequency, fever, chills, lumbar pain
hypertension involved in acute Pyelonephritis?
Nope.
4 common gram negatives that cause acute Pyelonephritis?
E.coli
Klebsiella
pseudomonas
proteus
What results from chronic Pyelonephritis? 3 things
interstitial scarring
tubular atrophy
saddle shaped scars
analgesic nephropathy is what?
from long term toxic analgesics less common now.
Treatment for End Stage Kidney Disease?
transplantation
dialysis
what does End Stage Kidney Disease kidneys look like
shrunken, pitted, scarred, rubbery pale
End Stage Kidney Disease reversible?
nope
End Stage Kidney Disease causes what to kidneys?
insufficient GFR, can’t eliminate waste
causes of End Stage Kidney Disease? top 3?
32% diabetic nephropathy
24% glomerulonephritis
14% hypertension
when do you start getting symptoms for End Stage Kidney Disease? at ___% renal function?
10%
