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18 Cards in this Set

  • Front
  • Back
general characteristics of renal failure
high creatinine (rapid increase)
oligouria
azotemia (elevated BUN)
renal failure b/c vascular compartment
Prerenal ARF
-low b flow
causes of prerenal ARF
decreased blood flow

hypotension
volume depletion
hemorrhage
sepsis
renal failure b/c kidney
Intrarenal ARF
causes of intrarenal ARF
Drug Induced Tubular necrosis (most common)
tubular or interstitial dz
renal failure b/c obstruction
Postrenal ARF
Tubulointerstitial diseases
Acute Tubular Necrosis (ATN cast)
-ischemic
-nephrotoxic

Drug Induced Interstitial Necrosis (eos, creat, WBC cast)

Acute Pyelonephritis (polis, casts, pus)

Chronic Pyelonephritis (cortex thin, thyroid)

Cast Nephropathy (lambda, kappa, frag'd casts, giant cells)
Pt w/burn, hemorrhage, or shock

Gross: pale cortex, swollen

brown, grannular casts in urine

LM: flat brush border, gunk in tubule
Acute Tubular Necrosis
Ischemic
Pt on Abs (sulfa drug), post contrast, heavy metal, carbon, poisons

LM: flat brush border, gunk in tubule, diffuse, cytoplasmic atypia
Acute Tubular Necrosis
Nephrotoxic
Pt on Abs, NSAIDs, Diuretics, Ace inhibs

HIGH creatinine
UA: WBC cast, eos, lymphos

LM: eos, lymphos, cellular, glom & vessels ok
Drug Induced Interstitial Nephritis
Pt post UTI, reflux, bacterial sepsis

B sx's, flank pain, CVA tender

UA: leuko casts, polis
Gross: pockets of pus
LM: inflamm, polis, WBC casts in tubules
acute pyelonephritis
Gross: polar scar
Histo: atrophy, scarring, contracted papillary tip, thin, pitted cortex, dilation

Thyroid like appearance
chronic pyelonephritis

untreated acute or obstruction/reflux
Cast Nephrophathy
Pt w/ myelomeloma, lymphoma

LM: fragmented casts, multinucleated giant cells

IMFL: kappa/lambda positive
tamm horsfall protein
protein componant of casts
acute tubular necrosis (key words)
brown grannular casts
flattened brush border
necrosis

nephrotoxic or ischemic
Drug Induced Interstitial Nephritis (keywords)
eosiniphils
WBC casts
ELEVATED creatinine
Acute Pyelonephritis (keywords)
WBC casts
pockets of pus
Polis
Chronic Pyelonephritis (keywords)
atrophy, scarring
cortical thinning (polar scar)
contracted papillary tip
thyroid-like