Term
| What causes pre-renal azotemia? |
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Definition
| Kidney hypoperfusion (from shock, hemorrhage, CHF, etc) |
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Term
| Acute Nephritic Syndrome characteristics |
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Definition
Hematuria
mild-moderate proteinuria
edema
HTN |
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Term
| Nephrotic Syndrome characteristics |
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Definition
heavy proteinuria (over 3.5g)
hypoalbuminemia
edema
hyperlipidemia
lipiduria |
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Term
| Stages of Chronic Renal Failure |
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Definition
1. Diminished Renal Reserve: GFR 50% of normal, BUN and creat. normal, asymptomatic
2. Renal Insufficiency - GFR 20-50% of normal, azotemia appears with HTN and anemia (sometimes polyuria and nocturia)
3. Renal Failure - GFR less than 20-25%, kidneys are unable to regulate volume, resulting in edema, metabolic acidosis, hypocalcemia, overt uremia
4. ESRD - GFR below 5%, terminal uremia |
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Term
| Systemic Manifestations of Chronic Renal Failure and Uremia |
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Definition
Fluid/Electrolytes: dehydration, edema, hyperkalemia, hypocalcemia, hyperphosphatemia, meatbolic acidosis
Hematologic: anemia (no EPO), bleeding diathesis
Ca/P/Bone: hypocalcemia, hyperphosphatemia, secondary hyperparathyroidism, renal osteodystrophy
Dermatologic: pruritis, dermatitis, sallow
GI: N/V, bleeding, esophagitis, gastritis, colitis
Cardiopulmonary: HTN, CHF, pulmonary edema, uremic pericarditis
Neuromuscular: myopathy, peripheral neuropathy, encephalopathy |
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Term
| List Congenital Renal Abnormalities |
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Definition
Kidney Agenesis
Hypoplasia
Ectopic Kidneys
Horseshoe kidneys |
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Term
| Course of Kidney Agenesis |
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Definition
Bilateral: incompatible with life
Unilateral: opposite kidney enlarges to compensate -> neurons hypertrophy -> glomerulosclerosis -> chronic renal failure |
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Term
| Difference between true hypoplasia and secondary hypoplasia |
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Definition
True hypoplasia: kidneys should have no scars, decreased numbers of renal lobes and pyramids
Secondary hypoplasia: acquired due to scarring from other processes |
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Term
| Histological Changes Seen with Glomerular Disease |
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Definition
1. Hypercellularity - associated with inflammation; see proliferation in mesangium and endothelium with leukocytes and crescents (if severe)
2. Basement membrane thickening - deposited immune complexes and materials or direct thickening (diabetes)
3. Hyalinization and Sclerosis - end result of glomerular damage |
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Term
| Poststreptococcal Glomerulonephritis |
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Definition
Presentation: acute nephritis
Pathogenesis: Ab-mediated against a circulating or a planted antigen
Pathology
LM - diffuse proliferation, leukocyte infiltrate
IF - granular IgG and C3 in GBM and mesangium
EM - subepithelial humps |
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Term
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Definition
Presentation: RPGN
Pathogenesis: Anti-GBM (COL4-A3 Antigen)
Pathology
LM - proliferation, crescents
IF - linear IgG and C3, fibrin in crescents
EM - no deposits, GBM disruption, fibrin |
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Term
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Definition
Presentation: RPGN
Pathogenesis: Anti-GBM Ab, immune complexes, ANCA
Pathology
LM - proliferation, focal necrosis, crescents
IF - linear IgG and C3, granular IgG, IgA and IgM, none
EM - none, deposits, none |
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Term
| Membranous glomerulonephropathy |
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Definition
Presentation: Nephrotic Syndrome
Pathogenesis: in situ Ab mediated, Ag unknown
Pathology
LM - diffuse capillary wall thickening
IF - granular IgG and C3, diffuse
EM - subepithelial deposits |
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Term
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Definition
Presentation: Nephrotic Syndrome
Pathogenesis: loss of glomerular polyanion, podocyte injury
Pathology
LM - Normal, lipid in tubules
IF - none
EM - loss of foot processes, no deposits |
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Term
| Focal Segmental Glomerulosclerosis (FSGS) |
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Definition
Presentation: Nephrotic Syndrome, non-nephrotic proteinuria
Pathogenesis: ablation nephropathy plasma factor, podocyte injury
Pathology
LM - focal and segmental sclerosis, hyalinosis
IF - Focal IgM and IgG
EM - loss of foot processes, epithelial denuding |
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Term
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Definition
Presentation: Nephrotic
Pathogenesis: Immune complex
Pathology
LM - mesangial proliferation and basement membrane thickening
IF - IgG, C3, C1q, C4
EM - subendothelial deposits |
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Term
| MPGN, Type II (Dense Deposit Dz) |
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Definition
Presentation: Hematuria, Chronic renal failure
Pathogenesis: AutoAb, alternative complement pathway
Pathology
LM - Mesangial proliferation, BM thickening
IF - C3 +/- IgG
EM - Dense deposits |
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Term
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Definition
Presentation: recurrent hematuria, proteinuria
Pathogenesis: unknown
Pathology
LM - focal proliferative GN, mesangial widening
IF - IgA +/- IgG, IgM and C3 in mesangium
EM - mesangial dense deposits |
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Term
| Chronic Glomerulonephritis |
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Definition
Presentation: Chronic renal failure
Pathogenesis: variable
Pathology
LM - hyalinized glomeruli
IF - granular, or none |
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