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35 Cards in this Set
- Front
- Back
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Renal Function
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1. Excrete Waste
2. Regulate Water and Sodium Balance 3. Acid-Base Balance 4. Secretion of hormones |
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Blood Urea Nitrogen (BUN)
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Amount of nitrogen in the blood that comes from urea.
Urea is normally excreted. |
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Creatinine
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Breakdown product of creatine phosphate in muscle.
Excreted by kidneys at a constant rate. |
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Azotemia
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Elevation of BUN and Creatinine levels due to DECREASED GFR
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Uremia
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Urea retained in the blood.
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Measuring Renal Function
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Plasma BUN, Creatinine, pH, Electrolytes
GFR rate=Creatinine clearance test |
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Glomerular diseases
(Glomerulonephritis) |
Usually Immune-Mediated
2 Types: 1. Circulating Immune Complex Nephritis 2. Immune Complex Nephritis in situ. |
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Circulating Immune Complex Nephritis
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Deposition of circulating antigen-antibody complexes in the glomeruli
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Immune Complex Nephritis in situ
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Antibodies are directed against components of the glomerulus
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Nephrotic Syndrome
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MASSIVE PROTEINURIA
Generalized edema (decreased osmotic pressure) Hyperlipidemia and lipiduria In kids, usually associated with minimal change disease. |
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Lipoid Nephrosis
Minimal Change Disease |
Manifests in young kids
Diffuse loss of foot processes, associated with loss of foot processes and nephrotic syndrome. 90% respond to CORTICOSTEROIDS |
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Membranous Glomerulonephritis
Membranous Nephropathy |
Characterized by immunoglobulin deposits along the GLOMERULAR BASEMENT MEMBRANE.
85% Idiopathic Glomeruli become SCLEROSED and HYALINZED Don't respond to corticosteroids |
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Nephritic Syndrome
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Characterized by:
Hematuria Oliguria Azotemia Hypertension INFLAMMATORY INFILTRATE AND GLOMERULAR CELL PROLIFERATION This leads to CAPILLARY DAMAGE |
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Poststreptococcal Glomerulonephritis
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Presents after recovery from Group A beta-hemolytic strep
Usually recovery is complete, but can progress to CRESCENTIC GLOMERULONEPHRITIS |
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Crescentic Glomerulonephritis
(Rapidly Progressive Glomerulonephritis) |
Presents with glomerular crescents and rapid loss of renal function
Crescents are monocytic infiltrate within Bowman's space 90% NEED A RENAL TRANSPLANT |
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Crescentic Glomerulonephritis Type I
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GOODPASTURE SYNDROME
Autoantibodies against Glomerular Basement Membrane (also Alveolar Basement Membrane) |
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Crescentic Glomerulonephritis Type II
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Complication of an immune complex nephritis
Infection or Systemic Lupus |
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Crescentic Glomerulonephritis Type III
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Pauci (less) Immune
Most have anti-neutrophil cyctoplasmic antibodies (ANCA) May be involved with Wegener's Granulmatosis |
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IgA Nephropathy
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Berger Disease
Deposition of IgA into the mesangium MOST COMMON GLOMERULAR DISEASE IN THE WORLD Gross hematuria 1-2 days after URT, GI, or UT infeciton |
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Chronic Glomerulonephritis
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End stage of several diseases.
Important cause of renal failure. Kidneys are symmetrically contracted with scarring and hyalinization. Secondary Hypertension, proteinuria, and azotemia Treatment=Transplant or dialysis |
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Acute Pyelonephritis
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Kidney Infection
Often associated with a UTI (E. coli is common) Pus and abscess formation in renal pelvis and calyces (pyonephrosis) PYURIA, bacteriuria, dysuria, polyuria |
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Chronic Pyelonephritis and Reflux Nephropathy
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UNEVEN scarring of kidneys and papillary blunting.
Usually caused by: 1. Obstructive lesions with recurring pyelonephritis 2.UTI infections with bladder and kidney reflux |
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Acute Tubular Necrosis (ATN)
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MOST COMMON CAUSE OF ACUTE RENAL FAILURE
Associated with disturbances in blood flow or toxic tubule injury. Caused by: Trauma, septicemia, poisons, drugs |
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Progression of ATN
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Initiating Phase: Slight decline in urine output with a BUN rise for 36 hours
Maintenance phase: Severe drop in urine output that lasts a few days to a few weeks. Recovery Phase: Steady increase in urine volume, but patient is susceptible to infections and electrolyte imbalances. |
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Drug Induced Interstitial Nephritis
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Acute Drug-Induced intersitial Nephritis
Analgesic Nephropathy |
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Acute Drug-Induced Intersitial Nephritis
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HYPERSENSITIVITY REACTION
Antibiotics, NSAIDS, thiazides, cimetidine. Characterized by: Fever, eosinophilia, rash, renal problems NOT DOSE RELATED Withdrawal of drug usually leads to recovery |
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Analgesic Nephropathy
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Chronic interstitial inflammation and papillary necrosis associated with large doses of analgesics.
Acetaminophen (tylenol) and aspirin. Typically occurs in patients with preexisting renal disease. |
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Diseases Involving Blood Vessels
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Malignant Hypertension
Autosomal Dominant (adult) Polycystic Kidney Disease Urolithiasis (renal Stones) Hydronephrosis |
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Malignant Hypertension
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Diastolic pressure >120 mmHg
Rapid Kidney Failure due to ISCHEMIA 90% of deaths due to uremia |
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Autosomal Dominant (adult) Polycystic Kidney Disease
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Multiple expanding cysts in both kidneys which destroy the renal parenchyma
SEVERE FLANK PAIN, intermittent gross hematuria, enlarged kidneys End-stage renal failure at about age 50 |
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Urolithiasis (Renal Stones)
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75% made of CALCIUM OXALATE
Hypercalcemia may be due to increased absorbtion or defective renal reabsorption SMALL STONES CAUSE RADIATING PAIN and hematuria |
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Hydronephrosis
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Dilation of renal pelvis and calyces with parenchymal atrophy caused by an OBSTRUCTION
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Kidney Tumors
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Renal Cell Carcinoma
Transitional Cell Carcinoma |
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Renal Cell Carcinoma
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80-90% of malignant renal tumors
Increase in smokers, cadmium exposure, and acquired polycystic diseases. Flank pain and hematuria Lung and Bone Metastases my be initial presentation |
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Transitional Cell Carcinoma
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Malignant BLADDER tumor
Painless Hematuria Smoking and industrial Solvents 5-year survival is 20% |
