Flashcards in Chronic Renal Failure CIS Deck (64)
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1
stage 1 CKD
GFR > 90
*diabetics
2
stage 2 CKD
GFR 60-89
3
stage 3 CKD
GFR 30-59
4
chronic kidney disease**
stage 3 for 3 months
5
70% of CKD**
HTN or DM
then GN and cystic disease
then prostate and tubulointerstitial disease
6
important signs of CKD
bone disease
anemia
broad waxy casts
paresthesias
bilateral small kidneys
7
decreased GFR causing HTN
decreased sodium > turns on sympathetics > turns on RAAS
therefore - get sodium and water retention
8
bone disease and CKD
PTH
-normally inhibits P reabsorption and increases Ca reabsorption
-CKD - no 1,25 hydrox of Vit D
-decreased PTH and no Ca reabsorption
9
phosphate vs. calcium
decreased GFR
-PTH can't get rid of P
-P goes up, and Ca goes down
10
decreased GFR and P/Ca
increased P and decreased Ca
11
Vit D metabolism
1 hydrox - liver
25 hydrox - kidney (prox tub)
-therefore don't get Vit D
-calcium low
12
low Ca
activates PTH release
-increased osteoclast bone resorption
-get osteitis fibrosia cystica
13
anemia and CKD
no erythropoietin
14
isosthenuria
same concentrated urine
-with CKD
15
waxy broad casts
chronic renal disease
16
subepithelial deposit humps
IgG and C3
hematuria and RBC casts
complement low
immune complex disorder
-post-infectious GN
shunt -staph
17
synpharyngitic hematuria
same time as infection
post-strep week later**
18
mesangium
IgA nephropathy
-most common in world
19
prognosis with proteinuria?
more proteinuria - gets worse
20
bergers disease
IgA nephropathy
-IgA1 - galactose deficiency in O-linked glycans
diseases with altered IgA - hepatic cirrhosis, HIV, CMV, celiac disease
21
IgA nephropathy with arthralgia, nausea, colic, melena, rash
henoch-schonlein
22
heamturia, rash, P-ANCA, RBC casts
microscopic polyangitis
23
P-ANCA
microscopic polyangitis (churg strauss)
-no granulomatous inflammation and no upper resp involvement**
24
C-ANCA
granulomatosis with polyangitis
-wegeners
25
pauci immune
not immune complex
-but instead neutrophil activation
ANCA type**
26
formation of ANCAs
MPO - antibodies to strong cations - pANCA
PR3 - antibodies to neutral/weak cations - cANCA
27
pANCA
anti-MPO - strong cations
28
cANCA
anti-PR3 - neutral/weak cations
29
anti-GMB disease
alpha 3 chain of type IV collagen
30
