Chapter 33 Disorders of Renal Function

Question 1

What are the most common fetal renal anomalies?

Answer 1

anomalies in the shape and position of the kidneys, decrease in size, or change in renal structure

Question 2

What causes a person to develop a horseshoe kidney

Answer 2

dysgenesis - failure of the organs to develop normally

Question 3

What are the examples of renal anomalies that involve decrease in size or kidney structure

Answer 3

agenisis which is failure of an organ to develop, and hypoplasia which is failure of an organ to reach the normal size so it is smaller than normal

Question 4

What is an example of renal fetal anomaly involving a change in renal structure

Answer 4

renal cysts

Question 5

what is the most common cystic disease of the kidney?

Answer 5

autosomal dominant polycystic kidney disease

Question 6

what are the manifestations of autosomal dominant polycystic kidney disease

Answer 6

high BP, blood in the urine, increased size of the belly from enlarged kidneys, headaches, kidney stones, kidney stones, kidney failure, UTI, kidney infections

Question 7

what is the average age of onset for autosomal dominant polycystic kidney disease

Answer 7

manifests after 40 years

Question 8

What is the treatment for autosomal dominant polycystic kidney disease?

Answer 8

dialysis or kidney transplant

Question 9

what is the cause for autosomal dominant polycystic kidney disease

Answer 9

mutations in the connective tissue that causes cysts to form

Question 10

What causes cysts on the kidney

Answer 10

tubular obstructions that increase intratubular pressure, changes in the membrane of renal tubules that predispose it to cysts

Question 11

What causes urinary tract obstructions?

Answer 11

developmental defects, calculi (stones), pregnancy, Benign prostatic hyperplasia, scar tissue (generally from repeat UTIs), spinal cord injuries

Question 12

How can you treat a urinary tract obstruction

Answer 12

stents in the urethra to promote flow of urine

Question 13

What is urine stasis and what does it cause?

Answer 13

when urine sits and isn’t expelled, it predisposes for infection and stone formation

Question 15

what are manifestions of urinary obstructions?

Answer 15

pain, signs and symptoms of UTIs, renal dysfunction, limited urine production

Question 15

What is an example of urinary obstruction?

Answer 15

hydronephrosis

Question 15

what is hydronephrosis?

Answer 15

obstruction causes dilation of renal pelvis and causes atrophy of the kidney – the kidney gets blocked and then the tissue starts to die - diagnosed with diagnostic imaging

Question 15

What are the 3 types of kidney stones and which is more common?

Answer 15

1. Calcium oxalate and calcium phosphate make up 70-80% of stones
2. struvite (magnesium, ammonium, phosphate) make up 15% of stones
3. Uric Acid makes up 7% of kidney stones

Question 16

What is the most common cause of a urinary tract obstruction?

Answer 16

kidney stones

Question 17

What are things that a person does that can predispose them to developing kidney stones?

Answer 17

eating foods high in oxalic acid like Brussel sprouts, and broccoli, and then also drinking well water that is generally higher in calcium than filtered water

Question 18

What are the clinical manifestations of kidney stones?

Answer 18

renal pain

Question 19

How do you diagnose kidney stones?

Answer 19

urinalysis, diagnostic imaging

Question 20

What is the treatment for kidney stones?

Answer 20

pain relief, promotion of the passage of the stone (drink lots of water), alteration in urine pH (drinking cranberry juice or light beer), and removal of the stones using percutaneous nephrolithotomy, ureteroscopy, extracorporeal lithotripsy with the goal of breaking the stone into smaller pieces that would be able to pass easier.

Question 21

What is glomerulonephritis?

Answer 21

inflammation of the glomeruli

Question 22

What causes glomerulonephritis?

Answer 22

cross reacting antibodies or circulating antigen-antibody complexes that get stuck in the glomeruli

Question 23

What can glomerulonephritis cause?

Answer 23

basement membrane thickening, sclerosis, fibrosis which can damage the filtration membrane, RBCs can escape into the urine, decrease in GFR which means the kidneys are not functioning as well

Question 24

What is the function of the glomerulus?

Answer 24

filter plasma and produce glomerular filtrate which then goes on to form urine

Question 25

What is a common sickness whose antibody complexes can get stuck in the kidneys and cause glomerulonephritis?

Answer 25

strep throat

Question 26

what are the clinical manifestations of glomerulonephritis?

Answer 26

proteinuria (protein in the urine), hematuria, low GFR, Azotemia (nitrogenous wastes in the blood), oliguria, hypertension and edema

Question 27

What is an example of glomerular diseases?

Answer 27

nephrotic syndrome

Question 28

What is nephrotic syndrome?

Answer 28

glomerular disease where there is damage to the clusters of small blood vessels in the kidneys that filter wastes and water from the blood, causes the body to pass too much protein in your urine

Question 29

What are clinical manifestations of nephrotic syndrome?

Answer 29

swelling in feet and ankles, hypoalbuminemia, lipiduria, dyspnea, susceptibility to infection

Question 30

What can cause nephrotic syndrome?

Answer 30

diabetes, hypertension, anything that can damage the capillaries

Question 31

Why can diabetes cause nephrotic syndrome

Answer 31

because diabetes and the fluctuations in blood sugar can damage the lining of blood vessels leading to damage.

Question 32

What is acute pyelonephritis?

Answer 32

acute infection of the ureter, renal pelvis, renal parenchyma (functional tissue of the kidney)

Question 33

What causes acute pyelonephritis?

Answer 33

UTIs

Question 34

What are the clinical manifestations of acute pyelonephritis?

Answer 34

flank pain, fever, chills, costovertebral tenderness, dysuria, pyuria (WBCs in the urine), white blood cell casts

Question 35

How do you treat acute pyelonephritis?

Answer 35

antibiotics

Question 36

What is chronic pyelonephritis?

Answer 36

recurrent infection of the kidneys that leads to scarring, inflammation and fibrosis which can lead to chronic kidney failure

Question 37

How would you treat chronic pyelonephritis?

Answer 37

antibiotics, prolonged antibiotics

Question 38

What are renal neoplasms?

Answer 38

renal tumors

Question 39

What are examples of renal neoplasms?

Answer 39

Wilms Tumor, adult kidney cancers

Question 40

What is Wilms tumor?

Answer 40

renal neoplasm that is an inherited embryonic kidney tumor, you might not necessarily be born with the tumor but as the kidney grows then the mutations also grow and divide and can cause tumors

Question 41

What is the onset age for Wilms tumors?

Answer 41

2-5 years old

Question 42

What is an example of an adult kidney cancer?

Answer 42

renal carcinoma

Question 43

What is renal carcinoma?

Answer 43

renal cancer

Question 44

What is the treatment for renal neoplasms?

Answer 44

radiation, chemo and/or surgery for removal of the tumor