Renal Pathophysiology Flashcards Preview

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Flashcards in Renal Pathophysiology Deck (28)
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1

Presentation of renal disease:

azotemia
uremia
proteinuria
hematuria
altered naturesis (leading to HTN)
edema
circulatory congestion

2

Azotemia:

elevated blood urea nitrogen and creatinine level
decreased glomerular filtration rate

3

uremia:

excess of urea and other nitrogenous waste in the blood
-failure of renal excretory function, host of metabolic and endocrine altercation
-secondary gastrointestinal, neuromuscular, and cardiovascular involvement

4

Acute kidney disease/injury/failure

-abrupt decrease in GFR or creatinine clearance
-RIFLE classification
-based on anatomical area of injury or malfunction:
prerenal
intrinsix
postrenal

5

RIFLE

-risk, injury, failure, loss of kidney function, and end-stage kidney disease

6

prerenal

decreased renal blood flow

7

intrinsic

structure within kidney damaged

8

postrenal

obstruction present within the urine collection system

9

chronic kidney disease

progressive loss of function over several months to years
gradual replacement of normal kidney with parenchymal fibrosis

10

hemodialysis

-perfusion of blood and dialysate on opposite side of semipermeable membrane
-substances removed by diffusion or convection
-excess water removed via ultrafiltration

11

peritoneal dialysis

instillation of dialysate into peritoneal cavity by permanent peritoneal catheter
-substances removed from blood across peritoneum via diffusion and ultrafiltration
-excess water removed by ultrafiltration created by osmotic pressure generated by various dextrose or icodextrin concentrations

12

drug-induced kidney disease

drug causes immune reaction, inflammation causes damage to structures of kidney
-antibiotics
-NSAIDs (analgesic nephropathy)

13

chronic glomerulonephritis

-most common causes of renal failure in humans
-divided into primary and secondary

14

secondary GN

associated with a number of systemic disease:
-SLE (systemic lupus erythrometitis-attack joints, skin lesions, kidney and spleen))
-diabetes (diabetic neuropathy)
-etc.

15

antibody-mediated glomerular injury (3)

1) immune complex (antibody/antigen) deposition- sub endothelial deposit, deposit in basement membrane:protein and blood leak out
2)anti-GBM (glomerular basement membrane) antibody
3) antibody against glomerular antigen (membranous nephropathy)

16

cell mediated

T-cell immune reaction: macrophages, mesangial cells

17

nephrotic syndrome

protein leakage only:
-proteinuria
-hypoalbuminemia
-edema
-hyperlidemia and lipiduria

18

nephritic syndrome

protein and RBC leakage
-hematuria
-oliguria (not enough urine)
-azotemia
-HTN

19

3 major glomerular syndrome

-nephrotic syndrome
-nephritic syndrome
-chronic glomerulonephritis

20

Chronic glomerulonephritis

-nephrosis
-nephritis

21

nephrosis

1) nephropathy (any disease of the kidney)
2) degeneration of renal tubular epithelium

22

nephritis

inflammation of the kidney

23

acute pyelonephritis pathways

1) hematogenous infection-bacterial spread (staphylococcus, E.coli)
2) ascending infection :urinary bladder infection, vesicoureterial reflux, intrarenal reflux

24

APKD acronym

autosomal dominant (adult) polycystic kidney disease

25

APKD definition

multiple expanding cyst of both kidneys, destroys intervening parenchyma

26

APKD pathogenesis

inherited mutation of PKD1 or PKD2 gene in renal tubular cells
-abnormal cyst formation in both kidneys
intermittent gross hematuria
HTN and urinary infection
ultimately fatal
renal transplantation necessary

27

Autosomal recessive (childhood) PKD pathogenesis

autosomal recessive inheritance
mutation in PKHD1-fibrocystin (polyductin)

28

Autosomal recessive PKD clinical features

-serious manifestation usually present at birth
-young infants dies quickly from pulmonary or renal failure
-patients who survive infancy develop liver cirrhosis (HTN)