Systemic Kidney Disease Flashcards
What haemodynamic changes does diabetes cause upon the kidney?
Afferent vasodilation mediated by vasoactive mediators (IGF-1)
Hyperfiltration
Increased GFR
Which lesions are typical of diabetic glomerulosclerosis?
Kimmelstiel-Wilson lesions
There is no need for renal biopsy for suspected diabetic nephropathy if there is co-inciding retinopathy. True/False?
True
The worse proteinuria is, the more likely the patient is to have diabetic complications. True/False?
True
Which type of transplant can be done for type 1 diabetics with nephropathy?
Dual pancreas-kidney transplant
Does reducing proteinuria slow progression of diabetic nephropathy? If so, which drugs can be used?
Yes
ACE inhibitor
What is the difference between renovascular hypertension and ischaemic renal disease?
RV hypertension is secondary hypertension due to renal artery stenosis
Ischaemic renal disease is due to hypoperfusion and reduced GFR
Name the 2 main renovascular diseases causing hypertension
Fibromuscular dysplasia
Atherosclerotic renovascular disease
ACE inhibitors are contraindicated in bilateral renal artery stenosis. True/False?
True
What happens in multiple myeloma? What is its effect on kidneys?
Cancer of plasma cells that causes Ig to accumulate in bone marrow
Produces protein that causes kidney problems
Which protein is produced by multiple myeloma that causes kidney problems?
Bence-Jones protein
Bence-Jones protein is usually picked up on urinalysis. True/False?
False
Urinalysis picks up albumin; BJ is abnormal protein that isn’t picked up
What is amyloidosis?
Deposition of protein in extracellular spaces
Describe amyloidosis on histopathology
Congo red staining showing apple-green birefringence
How is hypercalcaemia in myeloma causing renal failure treated?
NaCl volume resus
IV pamidronate if required
