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34 Cards in this Set
- Front
- Back
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Clots, crystals
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Non‐glomerular Hematuria
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Failure of the tubules to reabsorb normally filtered
proteins or increased secretion of tubular proteins |
tubular proteinuria)
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most common cause
of proteinuria and end end‐stage renal disease |
DM
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Fatty, hyaline casts
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nephrotic
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Malignancies (lymphoproliferative disease, e.g.
Hodgkin’s lymphoma) |
Minimal Change Disease
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Most common cause of primary nephrotic
syndrome in adults |
Membranous Nephropathy
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– Malignancy, primarily solid tumors
– SLE class V – Rheumatoid arthritis – Hepatitis B and C – Drugs (penicillamine, gold, captopril) – Syphilis |
Membranous Nephropathy
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– SLE class IV
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Diffuse glomerulonephritis
– Poststreptococcal GN – Bacterial endocarditis |
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– Poststreptococcal GN
– Bacterial endocarditis – Membranoproliferative GN – SLE class IV – Rapidly progressive GN |
• Diffuse glomerulonephritis
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• SLE (75‐90%)
• Subacute bacterial endocarditis (90%) • Cryoglobulinemia (85%) |
• Low serum complement level
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– Systemic diseases
• Vasculitis • Henoch‐Schonlein purpura – Renal diseases • IgA nephropathy • Rapidly progressive glomerulonephritis – ANCA associated GN – Anti‐GBM disease |
• Normal serum complement level
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Renal adaptation to prerenal azotemia
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maintain GFR by vasodilating afferent and constricting efferent
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Primary renal hemodynamic abnormalities that may cause prerenalazotemia
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• Renal artery stenosis, embolism, thrombosis
• *Medications (nonsteroidal anti angiotensin converting enzyme inhibitors) anti‐inflammatory agents, |
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NSAIDs can cause azotemia by what way
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Primary renal hemodynamic abnormalities
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multiple myeloma
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ATN
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Cr plateaus 7‐10 days
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ATN – time course
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BPH
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major cause of post renal acute kidney injury
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Echogenic
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Acute GN, ATN
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Normal echogenicity
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Prerenal AKI
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Enlarged kidneys
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HIV nephropathy, malignancy
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Postrenal AKI (obstruction) Tx
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– Foley catheter
– Ureteral stents – Nephrostomy tubes |
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Complications of AKI and Uremia: Whats the K like
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High up there
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Volume overload, pulmonary edema,
pericarditis |
Complications of AKI and Uremia: remember the K is high up there too
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Treat complications when GFR is
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30-59
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Estimate
progression when GFR is |
60-89
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prepare for transplat when GFR is
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15-29
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kidney failure when GFR is
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< 15
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target Ca x Phos product
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< 55
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calcium acetate, sevelamer,
lanthunum carbonate) |
Phosphate binders used in the rteartment of secondary hyperparathyroidism in chronic kidney disease
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• Benign urine sediment
• Minimal proteinuria |
Chronic Kidney Disease:
Hypertension |
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Vitamin D (calcitriol) or analogs how do they work in the context of chronic kidney disease
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• Vitamin D (calcitriol) or analogs PTH suppresses
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whats the sodium pH and Calcium like in chronic kidney disease
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low sodium low calcium and these patients may be acidotic
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Initiate dialysis when
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• Cr Cl < 10 mL/min, Cr > 8.0 mg/dL in non
diabetic patients • Cr Cl < 15 mL/min, Cr > 6.0 mg/dL in diabetic patients |
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Renal replacement therapy is usually required
when the GFR is |
< 10‐15 mL/min.
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