Strasinger AUBF - Renal Diseases

Glomerular disease

Immune complexes formed are deposited on the glomerular membranes

cellular infiltration damage

Complement-mediated damage to the capillaries and basement membrane

proliferation damage

Thickening of the glomerular basement membrane

Glomerulonephritis

Sterile, inflammatory process that affects the glomerulus

Glomerulonephritis

Associated with the finding of blood, protein, and casts in the urine

Acute glomerulonephritis

Deposition of immune complexes, formed in conjunction with group A streptococci infection, on the glomerular membranes

Rapidly progressive glomerulonephritis

deposition of immune complexes from systemic immune disorders on the glomerular membrane

Goodpasture syndrome

Attachment of a cytotoxic antibody formed during viral respiratory infections to glomerular and alveolar basement membrane

Wegener granulomatosis

Antineutrophilic cytoplasmic autoantibody binds to neutrophils in vascular walls producing damage to small vessels in the lungs and glomerulus

Henoch-Schonlein purpura

Occurs primarily in children following viral respiratory infections; a decrease in platelets disrupts vascular integrity

Membranous glomerulonephritis

Thickening of the glomerular membrane following IgG immune complex deposition associated with systemic disorders

Membranoproliferative glomerulonephritis

Cellular proliferation affecting the capillary walls or the glomerular basement membrane, possibly immune-mediated

Chronic glomerulonephritis

Marked decrease in renal function resulting from glomerular damage precipitated by other renal disorders

IgA nephropathy

Deposition of IgA on the glomerular membrane resulting from increased levels of serum IgA

Nephrotic syndrome

Disruption of the shield of negativity and damage to the tightly fitting podocyte barrier resulting in massive loss of protein and lipids

Minimal change disease

Disruption of the podocytes occurring primarily in children following allergic reactions and immunizations

Focal segmental glomerulosclerosis

Disruption of podocytes in certain areas of glomeruli associated with heroin and analgesic abuse and AIDS

Alport syndrome

Genetic disorder showing lamellated and thinning glomerular basement membrane

Acute glomerulonephritis

Rapid onset of hematuria and edema, permanent renal damage seldom occurs

Rapidly progressive glomerulonephritis

Rapid onset with glomerular damage and possible progression to end-stage renal failure

Goodpasture syndrome

Hemoptysis and dyspnea followed by hematuria with possible progression to end-stage renal failure

Wegener granulomatosis

Pulmonaary symptoms including hemoptysis develop first followed by renal involvement and possible progression to end-stage renal failure

Henoch-Schonlein purpura

Initial appearance of purpura followed by blood in sputum and stools and eventual renal involvement

Membranous glomerulonephritis

Slow progression to the nephrotic syndrome or possible remission

Membranoproliferative glomerulonephritis

Slow progression to chronic glomerulonephritis or nephrotic syndrome

Chronic glomerulonephritis

Noticeable decrease in renal function progressing to renal failure

IgA nephropathy

Recurrent macroscopic hematuria following exercise with slow progression to chronic glomerulonephritis

Nephrotic syndrome

Acute onset following systemic shock

Minimal change disease

Frequent complete remission following corticosteroid treatment

Focal segmental glomerulosclerosis

May resemble nephrotic syndrome or minimal change disease

Alport syndrome

Slow progression to nephrotic syndrome and end-stage renal disease

p-ANCA

Perinuclear pattern formed by the antibodies, formed when neutrophils are ethanol fixed

c-ANCA

Granular pattern throughout the cytoplasm when neutrophils are formalin fixed

Immunoglobulin A Nephropathy

Also known as Berger disease

Acute tubular necrosis

Damage to renal tubular cells caused by ischemia or toxic agents

Acute tubular necrosis

Acute onset of renal dysfunction usually resolved when underlying cause is corrected

Fanconi Syndrome

Inherited in association with cystinosis and Hartnup disease or acquired through exposure to toxic agents

Fanconi Syndrome

Generalized defect in renal tubular reabsorption requiring supportive therapy

Uromodulin-associated kidney disease

Inherited defect in the production of normal uromodulin by the renal tubules and increased uric acid causing gout

Uromodulin-associated kidney disease

Continual monitoring of renal function for progression to renal failure and possible kidney transplantation

Nephrogenic diabetes insipidus

Inherited defect of tubular response to ADH or acquired from medications

Nephrogenic diabetes insipidus

Requires supportive therapy to prevent dehydration

Renal glucosuria

Inherited autosomal recessive trait

Renal glucosuria

Benign disorder

Tubulointerstitial disease

Condition caused by disorders affecting the interstitium that also affects the tubules

Urinary tract infection

Most common renal disease

Cystitis

Ascending bacterial infection of the bladder

Cystitis

Acute onset of urinary frequency and burning resolved with antibiotics

Acute pyelonephritis

Infection of the renal tubules and interstitium related to interference of urine flow to the bladder, and untreated cystitis

Acute pyelonephritis

Acute onset of urinary frequency, burning, and lower back pain resolved with antibiotics

Chronic pyelonephritis

Recurrent infection of the renal tubules and interstitium caused by structural abnormalities affecting the flow of urine

Chronic pyelonephritis

Frequently diagnosed in children; requires correction of the underlying structural defect

Acute interstitial nephritis

Allergic inflammation of the renal interstitium in response to certain medications

Acute interstitial nephritis

Acute onset of renal dysfunction often accompanied by a skin rash but resolves following discontinuation of medication and treatment with corticosteroids

Acute renal failure

exhibit sudden loss of renal function and is reversible

End-stage renal disease

characterized by a marked decrease in glomerular filtration rate (<25 mL/min)

Prerenal causes of Acute Renal Failure

Decreased blood pressure / cardiac output, Hemorrhage, Burns, Surgery, Septicemia

Renal causes of Acute Renal Failure

Acute glomerulonephritis, Acute tubular necrosis, Acute pyelonephritis, Acute interstitial nephritis

Postrenal causes of Acute Renal Failure

Renal calculi, tumors

Renal lithiasis

kidney stones

Lithotripsy

procedure using high-energy shock waves, used to break stones located in the upper urinary tract into pieces that can then be passed in the urine

Calcium calculi

Frequently associated with metabolic calcium and phosphate disorders and occasionally diet

Magnesium ammonium phosphate calculi

Frequently accompanied by urinary infections involving urea-splitting bacteria

Uric acid calculi

Associated with increased intake of foods with high purine content and with uromodulin-associated kidney disease