Renal Flashcards by Nick DePaola

Acute Pyelonephritis involves

Tubules, interstitium, and renal pelvis caused by bacteria

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Acute pyelonephritis infection ascends

From the bladder or spreads to the kidney through the blood

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Acute pyelonephritis infiltration of _______ into ______

Neutrophils infiltration of intersittium and tubules

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Neutrophils casts

Cluster of neutrophils in the tubular lumens

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Predisposing condition of Acute Pyelonephritis

Urinary obstruction
Pregnancy 
Female
Diabetes 
Mellitus 
Immunosupression

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Drug induced interstitial nephritis can be caused by

Antibiotics, NSAIDs and Diuretics

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Drug Induced interstitial Nephritis—results from

Drug binding to tubular or interstitial cells and act as happen with immunogenicity response

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Drug Induced interstitial Nephritis symptoms

Rapid fever 2-40 days
Eosinophilia
Renal dysfunction with hematocrit but not proteinuria

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Acute Tubular Necrosis causes

Severe trauma
Ischemia
Septicemia
Texting

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Acute Tubular Necrosis pathologic features

Dilation of tubules
Edema
Necrosis of tubular epithelium

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Arterionephrosclerosis

Thickening and sclerosis of renal arteries associated with benign hypertension

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Arterionephrosclerosis gene affected

Apoliporotein L1 Gene

-Same linkage as in FSGS

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Arterionephrosclerosis Pathology

Grossly small kidneys, granular surface
Hyaline arteriosclerosis
tubular atrophy and fibrosis
Global sclerosis of glomeruli

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Thrombotic Thrombocytopenia Purpura

Acquired defect in metalloproteinase that degrades vWD

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Hemolytic-Uremic Syndrome

Endothelial injury from shiga toxin+ E. Coli

A major cause of acute kidney injury in children

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2 thrombotic micorangiopathies related to activation aggregation and consumption of platelets

TTP

HUS

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thrombotic micorangiopathies that is predominately kidney involved

HUS

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thrombotic micorangiopathies that is more widespread organ impacts induce CNS involvement

TTP

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Urolithiasis: 3 types of stones

Calcium

Magnesium ammonium phosphate; alkaline urine

Uris acid; gout, acid urine

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Causes of hydronephrosis

Renal stones
Obstruction (congenital )
Enlarged prostate
Neoplasm
Pregnancy 
Neurogenic bladder

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Hydronephrosis dilation of

Renal pelvis/calypso with parenchyma atrophy 2* to obstruction

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Renal cell carcinoma prognosis

stage dependent
5 year survival:
-Stage 1 81%
-Stage 4 8%

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Wilms Tumor

One of more common cancers in children 2-5

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Wilms tumor pathology

Triphasic proliferaiotn of cells with epithelial stroma and blastemal components

Prognosis very good

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Clear cell

Renal cell carcinoma Tumor often invades renal vein clear cells are common

Azotemia

Elevated BUN and creatinine due to decreased GFR

Uremia

Azotemia plus other symptoms

Acute Nephritic Syndrome

Proteinuria, hematuria, hypertension

Nephrotic syndrome

Severe proteinuria >3.5 grams per day | Low serum albumin high serum lipid

Acute Renal failure

Sudden onset of azotemia with oLiguria/anuria

Congenital Cystic Renal Diseases

Autosomal Dominant polycystic kidney disease Autosomal recessive childhood polycystic kidney disease

Autosomal Dominant (adult) polycystic kidney disease gene affected

PKD1 gene on chromosome 16—> defective protein polycystin-1

Autosomal Dominant (adult) polycystic kidney disease extrarenal pathology

Saccular berry aneurysms affecting circle of Willis

Autosomal Dominant (adult) polycystic kidney disease what happens to kidneys

Large kidneys predominated by numerous cysts

Autosomal Recessive Childhood polycystic Kidney gene mutation of

PKHD1 Defective protein-Fibrocystin

Autosomal Recessive Childhood polycystic Kidney extrarenal pathology

Liver cysts and progressive liver fibrosis

Autosomal Recessive Childhood polycystic Kidney results in

Numerous uniform size cysts that arise from collecting tubules Renal failure early in life

Glomerular disease mechanisms

Immune complex deposits in glomerular basement membrane or Mesa gum Anti GBM antibody Epithelial and endothelial cell injury

Nephrotic Syndrome Caused by

Increased glomerular capillary permeability to plasma proteins - minimal change Disease - Focal segmental glomerulosclerosis - Membranous nephropathy - Nodular glomeruclserosis

Nephrotic Syndrome traits

Heavy proteinuria Hypoalbuminai Severe edema Hyperlipidemai and lipiduria

Minimal Change Disease

Most common cause of nephrotic syndrome in CHILDREN Normal glomeruli No immune comple deposits Foot process effacement

Focal Segmental Glomerulosclerosis common cause of

Adult nephrotic syndrome | -Primary or secondary to other glomerular diseases

Focal Segmental Glomerulosclerosis pathology

Focal and segmental sclerosis with obliteration of capillary loops IF and EM- no immune complex in primary form

Which nephrotic syndrome responds to corticosteroid treatment

Minimal change Childhood

Membranous Nephropathy is most common in

Adults can be seen in children though

Membranous nephropathy may be primary or

Secondary to infection malignancy SLE or drugs

Membranous nephropathy Pathology

Nearly normal -LM Immune complex deposits -IF Deposits in subepithelial side of GBM- EM

Diabetes Mellitus Pathology

LM-Nodular glomerulosclerosis IF-No immune complex deposits EM-Thick GBM

Diabetes Mellitus changes

Haylain arteriosclerosis Atherosclerosis Nephrosclereosis

Nephritic Syndrome is characterized by

Acute onset of hematuria | Oliguria and azotemia, and hypertension

Nephrotic syndrome there is a proliferation

Of cells within the glomeruli accompanied by inflammatory cells

______ severally injures capillary walls in Nephritic syndrome

Inflammation

Nephritic syndrome results in

Blood passing into the urine as well as reduced GFR

Causes of Nephritic syndrome

Acute post infectious golmerulonephritis IgA nephropathy

Acute post infectious glomerulnephritis usually follows

Streptococcal pharyngitis Most common in children

Acute post infectious glomerulnephritis Pathologic findings

LM- profileration of endothelial and mesangial cells, inflammatory cells; may develop cellular crescents IF-immune complex deposition, granular EM-Immune complexes in GBM mesangium

IgA nephropathy affects

Children and young adults

IgA nephropathy hematuria 1-2 days post

Upper respiratory tract infection, resolves then recurs

Enoch Schonlein Purpura

When renal disease associated with Purpura skin rah GI pain arthritis (IgA nephropathy)

IgA nephropathy Pathology

LM-Variable mesangial cell proliferation IF and EM-immune complexes within mesangium

Rapidly Progressive Glomerulnephritis

Acute clinical syndrome not a specific form Progressive loss of real function SEVERE oligouria Death in weeks to month

Untreated glomerular diseae leads to

Loss of glomeruli and tubules with fibrosis

Renal Flashcards

(62 cards)