RENAL DISEASE Flashcards by Ruth Joy De Guzman

CLASSIFICATION OF RENAL DISEASES

1.Glomerular Disorder
2.Tubular Disorder
3.Interstitial Disorder

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Refers to sterile inflammatory processes that
affects the glomerulus and associated with the
finding of blood, protein and casts in urine

Glomerulonephritis

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Sudden onset of symptoms with
consistent damage to the
glomerular membrane

Acute Poststreptococcal Glomerulonephritis

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symptoms of Acute Poststreptococcal Glomerulonephritis

 Fever
 Hypertension
 Edema
 Oliguria
 Fatigue
 Hematuria

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Acute Poststreptococcal Glomerulonephritis caused by:

Streptococcus
pyogenes
Pneumonia
endocarditis
Severe infection

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FINDINGS for Acute Poststreptococcal Glomerulonephritis

Hematuria
Proteinuria
Oliguria
Presence of casts (RBC cast, WBC casts, Hyaline Casts,
Granular Casts)
Increased BUN Levels
POSITIVE ASO Titer

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Damage to capillary wall is due to macrophages that
will release cells and plasma in the Bowman’s space

Rapidly Progressive (Crescentic) Glomerulonephritis

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Findings for Rapidly Progressive (Crescentic) Glomerulonephritis

Similar to AGN
Elevatted protein levels
Very low GFR

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Production of crescentic formations containing
macrophage, fibroblast and polymerized fibrin

Rapidly Progressive (Crescentic) Glomerulonephritis

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Autoantibody attachment and complement activation
causes the damage to the capillaries.

Goodpasture Syndrome

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urine findings for goodpasture syndrome

Macroscopic hematuria
Proteinuria
RBC casts

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Due to the cytotoxic antibody (Antiglomerular Basement
membrane) found attached to the glomerular and
alveolar membranes during viral respiratory infection

Goodpasture Syndrome

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Patient’s initial complaints when they have goodpasture sydrome

hemoptysis & dyspnea

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Disorders affecting the systemic vascular system
resulting to the glomerular damage

Vasculitis

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two types of Vasculitis

Wegener’s Granulomatosis
Henoch- Schönlein Purpura

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It is considered as an immune complex disease and is
characterized by involvement of capillaries with diffuse
infiltration of neutrophils, lymphocytes and macrophages

Henoch- Schönlein Purpura

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caused by antineutrophilic cytoplasmic antibody
(ANCA), which can be demonstrated in patient’s
serum for laboratory testing

Wegener’s Granulomatosis

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Result of allergic vasculitis which involves the skin, GIT,
kidneys, heart and CNS

Henoch- Schönlein Purpura

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causes granuloma producing inflammation of the
small blood vessels in the lungs and the kidneys

Wegener’s Granulomatosis

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Patient’s serum IgA level is increased which may result
from mucosal infection

Immunoglobulin A Nephropathy/ Berger’s Disease

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Thickening of the glomerular membrane due
to deposition of IgG immune complexes

Membranous Glomerulonephitis

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DISORDERS ASSOCIATED with Membranous Glomerulonephitis

Systemic Lupus Erythematosus
Sjögren Syndrome
Secondary syphillis
Hepatitis B
Gold & mercury treatment
Malignancy

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Nephrotic Syndrome occurs

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Membranous Glomerulonephitis

Immune mediated disorder mostly affecting children characterized by
cellular proliferation in capillary walls or glomerular basement membrane

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Membranoproliferative Glomerulonephitis

Increased cellularity in the subendothelial cells of the (mesangium) interstitial area of the Bowman’s capsule, causing thickening of the capillary walls

Type I

Extreme dense deposits in the glomerular membrane

Type II

Glomerular damage as a result of renal disorder leads to marked decreased in renal functions and eventually to renal failure

Chronic Glomerulonephritis

findings for Chronic Glomerulonephritis

hematuria proteinuria glucosuria Cast ( broad cast) Dec GFR Inc BUN, Creatinine level Imbalance electrolytes

There is increase permeability of the glomerular membrane due to disruption in the electrical charges in the basal lamina and podocytes, producing a less tightly connected barrier that allows massive loss of protein and lipids

Nephrotic Syndrome

Primary Urinalysis Result for Nephrotic Syndrome

Heavy proteinuria Microscopic hematuria Renal tubular cells Oval fat bodies Fat droplets Fatty and waxy casts

Podocytes appear to be less tightly fitting allowing increase infiltration of protein

Minimal Change Disease (Lipid Nephrosis)

Urinalysis results for Minimal Change Disease (Lipid Nephrosis)

Heavy proteinuria Transient hematuria Fat droplets

The disease is caused by the disruption of podocytes associated with analgesic and heroin abuse and AIDS.

Focal Segmental Glomerulosclerosis

seen in the undamaged glomerulus

IgM and C3

an inherited disorder affecting the glomerular basement membrane

Alport Syndrome

increased proliferation of mesangial cells and increased deposition of cellular and noncellular material within the glomerular matrix resulting in accumulation of solid substances around the capillary tufts

Diabetic Nephropathy

glomerular basement membrane has a lamellated appearance with areas of thinning

Alport Syndrome

Diabetic Nephropathy also known as

Kimmelstiel-Wilson disease

currently the most common cause of end-stage renal disease.

Diabetic Nephropathy

primary disorder associated with damage to the renal tubules

Acute Tubular Necrosis

disorder most frequently associated with tubular dysfunction

Fanconi’s Syndrome (Hereditary)

Associated with exposure to toxic agents

Acquired

2 types of Hereditary and Metabolic Disorder

- Fanconi’s Syndrome - Acquired

Disorders affecting the renal interstitium which also affects the tubules

INTERSTITIAL DISORDER (tubulointerstitial disease)

Ascending bacterial infection of the bladder

Cystitis

Infection of the renal tubules and interstitium related to interference of urine flow to the bladder, reflux of urine from the bladder, and untreated cystiti

Acute pyelonephritis

urinary result of Acute pyelonephritis

Hematuria Proteinuria Leukocyturia WBC casts

urinary result of Chronic pyelonephritis

* Leukocyturia * Bacteriuria * WBC casts * Bacterial casts * Granular, waxy, broad casts * Hematuria * Proteinuria

Decreased glomerular filtration rate

Chronic Renal Failure

Acute Renal Failure Prerenal causes:

Burns Hemorrhage Surgery

Acute Renal Failure Renal Causes:

Acute glomerulonephritis Acute pyelonephritis Acute tubular necrosis

Acute Renal Failure Post Renal Causes:

Tumors Calculi Crystallization of ingested substancces

GENERAL CHARACTERISTICS OF ACUTE RENAL FAILURE

*Decrease in GFR *Oliguria *Edema *azotemia

Deposition of renal calculi or kidney stones in the calyces and pelvis of the kidney, ureters and urinary bladder

RENAL LITHIASIS

- a procedure using high-energyshock waves, to break stones located in the upper urinary tract into the pieces that can be then passed in the urine

lithiotripsy

CONDITIONS FAVORING STONE FOMATION

 pH  Chemical concentration  Urinary stasis  Cystine

RENAL DISEASE Flashcards

(56 cards)