Pathology of the Kidneys and UUT Part 4 Flashcards

Flashcards for Pathology of the Kidneys and UUT Part 4 lecture.

Urolithiasis

Commonly known as kidney stones; concentrated urine results in higher amounts of minerals and acid salts that stick together to form calculi.

Urolithiasis Symptoms

Severe pain, and can cause obstruction distal to the calculi.

Urolithiasis US presentation

Very echogenic with posterior shadowing.

• Tiny renal and ureteric stones won't cause posterior shadowing 

• So by putting colour doppler on it, calculus will show twinkle artefact

• Variants observed: small calyceal stones, stones in the renal pelvis (both with and without renal dilation).

  

Medullary Sponge Kidney

Congenital, rare, benign condition involving dilation of collecting tubules in renal papillae.

Medullary Sponge Kidney US appearance

Hyperechoic foci in the region of the renal papillae

Involves dilatation of collecting tubules in renal papillae, leading to sponge-like cavitary regions in one or both kidneys; echogenic medullary pyramids

 May contain Nephrocalcinosis.

Nephrocalcinosis

Formation of calcium in the distal tubules and loops of Henle

 Increased calcium levels in the kidney

Nephrocalcinosis Causes

Hypercalcaemia due to hyperparathyroidism, some medications, sarcoidosis, tuberculosis, AIDS-related infections, or Vit D toxicity.

Nephrocalcinosis Clinical Presentation

Asymptomatic

Hyperparathyroidism

Hypercalcemia

Hypercalciuria

Nephrocalcinosis US presentation

Calcifications primarily in the medullary pyramids with posterior shadowing dependent on the amount of calcification.

Renal Artery Stenosis (RAS)

Narrowing of the renal artery, leading to renovascular hypertension.

Renal Artery Stenosis (RAS) Causes

Atherosclerosis (at origin) or fibromuscular dysplasia (in distal artery).

Renal Artery Stenosis (RAS) Clinical Presentation

Hypertension that cannot be medically controlled.

Renal Artery Stenosis (RAS) US presentation

Stenosis seen on color Doppler; smaller kidney on the side with RAS.

Renal Infarction

No blood flow to the kidney due to thromboemboli or thrombus, can involve whole kidney or partial (wedge-defect).

Renal Infarction Clinical Presentation

Pain, N/V/Fever, Hypertensive.

Obstructive Nephropathy

Renal changes due to urine blockage, causing urine to back up into the kidney and the kidney becomes swollen.

Obstructive Nephropathy US presentation

Hydronephrosis (uni- or bilateral), changes to renal arterial hemodynamics, thinned parenchyma (long-term).

Renal Transplantation

Necessary when a person's own kidneys no longer filter their blood -- ESKD.

Renal Transplantation Early Days US Request

Size, vascular supply issues/leaks, ureter leaks, hematoma, urinoma, abscess, seroma, lymphocele.

Renal Trauma Results

Lacerated kidney, Hematoma - perirenal or within kidney, Urinoma.