Chapter 7 Pathy

Front 1

glomerulonephritis

Back 1

Inflammation of the kidney glomerulus. Acute glomerulonephritis may develop as part of a systemic disorder ( a condition that affects many organs in the body) or may be idiopathic. It can also occur after an acute infection, as in postreptococcal glomenrulibeogrutus. In this condition, which appears 10-14 days after a streptococal infection, no bacteria are actually found in the kidney, but inflammation results from an immune (antigen and antibody) reaction in the glomerulus. Most patients recover spontaneously, but in some cases the disease becomes chronic. Chronic glomerulonephritis can result in hypertension (high blood pressure), albuminuria (due to seepage of protein through damaged glomerular walls), renal failure, and uremia. Drugs may be useful to control inflammation, and dialysis or renal transplantation may be necessary if uremia occurs.

Front 2

intestitial nephritis

Back 2

Inflammation of the renal interstitium (connective tissue that lies between the renal tubules). Acute interstitial nephritis, an increasingly common disorder, may develop after the administration of drugs. This condition is characterized by fever, skin rash, eosinophilis in the lood and urine, and poor renal function; recovery may occur when the patient discontinues using the offending agent. Recovery is helped with corticosteroids (anti-inflammatory agents).

Front 3

nephrolithiasis

Back 3

Kidney stones (renal calculi). Kidney stones usually are composed of uric acid or calcium salts. Although the eitology often remains unclear, conditions associated with an increase in the concentration of calcium (parathyroid gland tumors) or high levels of uric acid in the blood (hyperuricemia--associated with gouty arthritis) may contribute to the formation of calculi. Stones often lodge in the ureter or bladder, as well as in the renal pelvis, and may require removal by lithotripsy or surgery.

Front 4

nephrotic syndrome (nephrosis)

Back 4

A group of clinical signs and symptoms caused by excessive protein loss in the urine. In addition to marked proteinuria, clinical manifestations include edema (swelling caused by fluid in tissue spaces), hypoalbuminemia, hypercholesterolemia, hypercoagulability (tendency of the glood to clot more than normal), and susceptibility (tendency of the blood to clot more than normal), and susceptibility to infections. Nephrotic syndrome may follow glomeulonephritis, exposure to toxins or certain drugs, and other pathologic conditions, such as diabetes mellitus and malignant disease. Particular drugs may be useful to heal the leakly glomerulus.

Front 5

polycystic kidney disease (PKD)

Back 5

Multiple fluid-filled sacs (cysts) within and on the kidney. This hereditary condition usually remains asymptomatic (without symptoms) until adult life. Cysts progressively develop in both kidneys, leading to nephromegaly, hematuria, urinary tract infection, hypertension, and uremia.

Front 6

pyelonephritis

Back 6

Inflammation of the renal pelvis and renal medulla. Bacterial infection causes this urinary tract infection. In acute pyelonephritis, many small abscesses (collections of pus) form in the renal pelvis and adjacent medulla. Urinalysis reveals pyuria. Treatment consists of antibiotics and surgical correction of any obstruction to urine flow.

Front 7

renal cell carcinoma (hypernephroma)

Back 7

Cancerous tumor of the kidney in adulthood. This tumor accounts for 2% of all cancers in adults. Hematura is the primary abnormal finding, and the tumor often metastasizes to bone and lungs. Likelihood of survival depends on the extend to spread of the tumor. Nephrectomy is the treatment of choice. There are now effective treatments using anti-angiogenic drugs that block the growth of new blood vessels.

Front 8

renal failure

Back 8

Failure of the kidney to excrete wastes and maintain its filtration function. The kidney stops excreting nitrogeneous waste products and acids derived from diet and body metabolism. Renal failure may be acute or chronic, reversible or progressive, mild or severe. A new classification of chronic kidney disease (CKD) stages patients according to the level of creatinine clearance, ranging from normal (stage 1) to end-stage renal failure (stage 5). Erythropoietin is used to treat patients with CKD (stage 3 to 5).This substance increases red blood cells, resulting in marked improvement in energy levels. Hemodialysis, peritoneal dialysis, and renal transplantation are advised when medical measures have been exhausted.

Front 9

renal hypertension

Back 9

High blood pressure resulting from kidney disease. Renal hypertension is the most common type of secondary hypertension (high blood pressure caused by an abnormal condition, such as glomerulonephritis or renal artery stenosis). If the cause of high blood pressure is not known, it is called essential hypertension. Chronic essential hypertension causes arterial and arteriolar damage, potentially resulting in stroke, myocardial infarction (heart attack), heart failure, and renal failure.

Front 10

Wilms tumor

Back 10

Malignant tumor of the kidney occuring in childhood. This tumor may be treated with surgery, radiation therapy, and cheomtherapy.

Front 11

bladder cancer

Back 11

Malignant tumor of the urinary bladder. The bladder is the most common site of malignancy of the urinary system. It occurs more frequently in men (often smokers) and in persons older than 50 yrs of age, especially industrial workers exposed to dyes and leather tanning agents. Signs and symptoms include gross (visible to the naked eye) or microscopic hematuria and dysuria and increased urinary frequency. Cystoscopy with biopsy is the most common diagnostic procedure. Staging of the tumor is based on the depth to which the bladder wall (urothelium) has been penetrated and the extent of metastasis. Superficial tumors are removed by electocauterization (burning). Cystectomy, chemotherapy, and radiation therapy are helpful for more invasive disease.

Front 12

diabetes insipidus

Back 12

Inadequate secretion or resistance of the kidney to the action of antiduretic hormone (ADH). Two major symptoms of this condition are polydipsia and polyuria. Lack of ADH prevents water from being reabsorbed into the blood through the renal tubules. Insipidus means tasteless, reflecting very dilute and watery urine, not sweet as in diabetes mellitus. The term diabestes comes from the Greek diabainein, meaning to pass through. Both types of diabetes (insipidus and mellitus) are marked by polyuria (excessive excretion of urine).

Front 13

diabetes mellitus

Back 13

Inadequate secreton or improper utilization of insulin. The two major signs and symptoms of diabetes mellitus are glycosuria, hyperglycemia, poluria, and polydispsia. Without insulin, sugar cannot leave the bloodstream and be available to body cells for energy. Sugar remains in the blood (hyperglycemia) and pills over into the urine (glycosuria) when the kidney cannot reabsorb it through the renal tubules. Mellitus means sweet, reflecting the content of the urine. The term diabetes, when used aone, refers to the more common condition diabetes mellitus, rather than diabetes insipidus.