case 7 - diabetic kidney disease Flashcards
what is the basic membrane comprised of
glomerular
Tubular
Bowman’s Capsule
what is the interstitial membrane comprised of
mesangium
Tubulointerstitium
what are the different cellular and matrix defects
matrix expansion
Sclerosis
Podocyte detachment
Mesangial cell proliferation
what would a urine dipstick show
a protien leak
what is the most common type of proteinuria
glomerular
what is glomerular proteinuria
most common, up to 90%
Feature of chronic kidney disease
Loss of albumin and higher molecular weight proteins
what is tubular proteinuria
low molecular weight proteins such as beta2-microglobulin
what is overflow proteinuria
increased production that is light chains in multiple myeloma
what is post-exercise proteinuria
transient benign
Can be up to 10g/day
what is post-pradial proteinuria
transient physiological proteinurinia
Possibly through insulin action in podocytes
what is infection associated proteinuria
physiological response
Mediated by toll-receptors
Possibly involved in clearing pathogens from the circulation
what is normal PCR and what is the nephrotic range
*Protein:creatinine ratio (PCR)
–<20mg/mmol (normal)
–200mg/mmol (nephrotic range)
what is the ACR normal value and what value suggests albuminuria
–>3 mg/mmol (microalbuminuria)
–>30 mg/mmol (albuminuria)
what are the stages of injury in diabetic nephropathy
hyperfiltration
Microalbuminuria
Microalbuminuria
Proteinuria
Declining renal function
what is the pathology behind diabetic nephropathy
Glomerular;
GBM thickening
Mesangial expansion
Nodular sclerosis
Advanced sclerosis
tubule-interstitial
Vascular
