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22 Cards in this Set
- Front
- Back
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Proximal Tubule Function |
Re absorbs 50% sodium (H+/NA+ exchange) Reabsorbes bicarb Absorbs all glucise and amino acids PTH acts here to increase phosphate & Vit D reabsorption |
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Loop of Henle |
40 % of sodium reabsorption Main water reabsorption place Loop diuretics block Na+/K+/2Cl- co transporter |
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Distal tubule |
5 % sodium reabsorption Thiazide diuretics 1st part - block Na/Cl cotransporter |
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Collecting duct |
Spirinolactone blocks Na/K exchange Lithium inhibits ADH |
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Nephrotic |
>3..5g protein / 24h Glomerular diseasea |
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CASTS 1) Tubular cells 2) Hyaline 3) Granular 4) Red Cell 5) Leukocytes |
1) ATN / intestitial nephritis 2) Tamm-Horsfall glycoprotein (seen in N pop) 3) non-specific 4) glomerulonephritis or tubular bleeding 5) pyelonephritis or ATN |
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RTA vs renal failure on ABG |
RTA - normal anion gap renal failure - increased anion gap (excess amonia) |
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Type 1 RTA |
Common Distal Impaired urinary acidification e.g. poor H+ excretion Urine pH>5.3 Plasma HCO3- <10 Plasma K+ low Complcations - nephrocalcinosis, calculi, poor growth, infections |
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Type 2 RTA |
Proximal Rare Failure of HCO3- reabsorption Bicarb 14-20 A.w osteomalacia, rickets, faconi syndrome |
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Faconi syndrome |
Phosphaturia, glycosuria, aminoaciduria |
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CAuses of Type 1 RTA |
Primary - genetic (AD) or idiopathic Secondary to AI - SLE, sjogren Tubulointerstitial - chronic pyelonephritis, transplant rejection, obstructive uropathy, chronic interstitial nephritis Nephrocalcinosis - medullary sponge kidney, myeloma, amyloidosis Drugs and toxins - lithium, amphotericin, toluene |
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Causes of Type 2 |
Idiopathic With Fanconi - Wilson's, cystinosis, fructose intolerance, sjogren's Tubulointerstitial - interstitial nephritis, myeloma, amyloidosis Drugs and toxins: tetracyclins, lead, mercury, acetozolamide, sulfonamides |
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Type 4 RTA |
mineral corticoid deficiency metabolic acidosis + hyperkalaemia. Low renin low aldoseterone - DM, NSAIDS, Ciclosporin low renin, low aldosterone: adrenal destruction, ACEi/ARB |
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Bartter |
Like fruosemide - inactivation of Na/K/Cl transporter Hypotension, hypokalaemia, High levels of chloride in urine |
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Liddle's |
Like Conns Hypertension, hypokalaemia, AD low renin and aldosterone No response to spirinolactone |
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Gitelman |
Like thiazides AR/AD Hypocalciuria, hypomagnesaemia Hypotension Hypokalaemia Later onset than Bartter |
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Stage 1 AKI Stage 2 AKI Stage 3 AKI |
1) <0.5ml/lg/h >6hours. SCr increased by >26micromol/L or 1.5-1.9 x reference 2) <0.5ml/lg/h >12hours or >2.0-2.9 x reference SCr 3) <0.5ml/lg/h >24hours/anuria or >3x reference or >354 micromol |
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Minimal Change |
Nephrotic Children NSAIDs/Gold Tx: prednisolone |
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Membranous |
Proteinuria, nephrotic (mild haematuria) may cause CKD age - mid 20s or 60-70 IgG deposit in GBM Tx ACEi ARB May be secondary to malignancy, SLE, RA, Sjogren, chronic infections, drugs (gold, penicillamine, captopril, nsaids.) Sarcoid, Guillan BArre, PBC. |
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FSGS |
Protein ++, nephrotic a/w CKD & AKI. Primary - Ig G deposits secondary - due to HIV, heroin, obesity |
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Mesangioproliferative/IgA |
Most common priamry GN in adults esp young men AI IgA component |
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Mesangiocapillary |
Type 1 - immune deposits in subendothelial space. A/w cryoglobulinaemia, hep C. Type 2: mesangiam deposits. Familial Type 3: both and Hepb/c Tx with steroids |
