Tubulointerstitial Disorders Flashcards
Disorders that affect interstitial space surrounding the renal tubules
tubulointerstitial disease
True or false: tubulointersitial disease can be acute or chronic?
True
Chronic conditions of tubulointerstitial disease include
fibrosis and atrophy
Acute conditions of tubulointerstitial disease include
rapid onset characterized mainly by edema
Infection of kidney tissue and pelvis
pyelonephritis
True or false: pyelonephritis is only acute
False
It can be acute or chronic
Main cause of acute pyelonephritis?
hematogenous spread of bacteria or infection via the urethra or instrumentation (catheters)
What type of bacteria in pyelonephritis?
gram-negative
E.coli or Enterococcus faecalis
pus in urine
pyuria
Causes of chronic pyelonephritis?
ideopathic or associated with renal obstruction or reflux
abscess formation
recurrent or persistent infection from urinary obstruction or urinary reflux
s/sx acute pyelonephritis
flank pain
fever/chills
frequency
dysuria
Most common cause of rapid acute kidney failure
acute tubular necrosis
What are the 2 categories of ATN
ischemic
nephrotoxic
What type of ATN results from decreased perfusion or inadequate oxygenation to renal tubules
ischemic
What type of ATN results from a number of agents that directly and specifically damage the renal tubules
nephrotoxic
Name risks for ATN
blood transfusion reactions
injury or trauma to the muscles (rhabdomyolosis)
recent surgery
exposure to direct toxins (drugs or infection)
A direct toxin to kidneys
myoglobin
Serious clinical consequences such of CHF and pulmonary edema from acute renal failure are r/t
metabolic acidosis
e-lyte imbalances
fluid imbalances
Three phases of ATN
initiation
maintenance
recovery
Which ATN phase is characterized by oliguria and has most fatalities in this phase
maintenance phase
What is morbidity and mortality during maintenance due to?
rentention of waste products
fluid retention
development of HTN
What phase of ATN is dominated by azotemia and usually lasts several hours
initiation phase
The ATN phase that is characterized by profuse diuresis with continued recovery of renal function
recovery phase
True or false: ATN is not reversible
False
It is treatable and reversible
The treatment of ATN focuses on preventing the excess buildup of fluids and wastes, while allowing the kidneys to heal.
The decrease in urine output is due to
decreased GFR
