Systems pathology- kidney

Question 1

Name 4 functions of the kidney

Answer 1

excretion of nitrogenous waste
salt, iron, water homeostasis
secretion of EPO
secretion of renin

Question 2

What is acute kidney injury also known as?

Define it

Answer 2

Acute renal failure

Abrupt deterioration of renal function

Question 3

List three features of acute kidney injury

Answer 3

Oliguria leading to anuria
Electrolyte imbalance-hyperkalemia and metabolic acidosis
Rapidly rising blood urea and creatinine

Question 4

What are the causes of AKI?

Answer 4

Pre renal causation
Intrinsic acute kidney disease-glomerular, vascular, tubulo-interstitial
Post renal acute injury

Question 5

Describe pre renal causation

Answer 5

Response to reduced renal perfusion
Kidneys attempt to retain Na and water (RAA activation) impaired
Occurs in shock-bleeds, burns, sepsis
Cardiac failure
Treat- increase perfusion pressure

Question 6

Describe glomerulonephritis

Answer 6

Immune complex mediated disease of glomeruli
Some- rapidly progressive
Some- post infective
Some linked to vasculitis

Question 7

What does nephrotic syndrome involve

Answer 7

obliteration of glomerular lumina

1. immune complexes deposited in fenestrations
2. destroy basement membrane -haemuria
3. capillary epithelia over proliferates causing a blockage of glomerular capillary lumen

Question 8

Define chronic renal failure

Answer 8

Slowly progressive and irreversible loss of renal function due to irreversible destruction of large numbers of nephrons

Question 9

What are the causes of chronic kidney disease

Answer 9

Diabetic kidney disease
Congenital kidney diseases (e.g. polycystic)
Immunological damage to all glomeruli, called “glomerulonephritis”
Chronic renal reflux
Infection (Hep B, Hep C, Malaria, TB, HIV)

Question 10

Describe glomerular disease

Answer 10

Thickening of basement membrane and mesangium

• Diabetic glomerular disease
• Membranous glomerulonephritis