Renal cystic and vascular Dz + Stones/obstruction Flashcards
mutation in ADPKD
AD ∆APKD1/2
what other conditions are a/w ADPKD
berry aneurysms and liver cysts
cystic dilation of collecting
ducts → hematuria,
recurrent UTIs, kidney stones
Dx?
Medullary sponge kidney
IV pyleo with sponge like calyx
treatment for simple renal cyst
leave it alone
renal artery stenosis, what happens?
how is it dx and tx? etiologies?
RA stenosis → ↓renal blood flow → kidney thinks you’re hypotensive → RAA system → HTN, abdominal bruits, ↓renal function
Dx with renal arteriogram (if pt is in renal failure, use MRA instead since dye is nephrotoxic)
Tx angioplasty
Etiology: fibromuscular dysplasia
(young women), atherosclerosis
(old men)
flank pain, HTN, hematuria, proteinuria
how to dx?
RV thrombosis
Dx with renal venography
benign vs malignant HTNivs nephrosclerosis
Benign nephrosclerosis: hyaline
arteriolosclerosis in chronic
HTN
Malignant nephrosclerosis:
hyperplastic (“onion skin”)
arteriolosclerosis in rapidly
progressive HTN
SCD causes what kind of renal pathology
Tx?
papillary infarction/necrosis
ACEi (w/ hydroxyurea for SCD)
MC type of kidney stone
Calcium stone
only randiolucent stone
uric acid
can form large staghor caliculi
struvite
etiologies of… + treatment
- Ca stones
- uric acid stones
- struvite stones
- cystine stones
- Ca stones = hypercalciuria or hyperoxaluria | PPx with HCTZ
- uric acid stones = gout or tumor lysis syndrome | PPx with allopurinol, Tx with Potassium citrate
- struvite stones = urease + bugs (P.mirabilis)
- cystine stones = cystinuria | acetazolamide
Dx with urinary sodium nitroprusside test
cystine stones
Treatment for all stones
Tx
analgesics + fluids (<0.5 cm)
shockwave lithotripsy (0.5 – 2 cm), percutaneousnephrolithotomy (≥2 cm)
Kidney stone diet:
Kidney stone diet: high fluids
(#1), low sodium, low protein,
high calcium (counterintuitive),
low oxalate
