Renal Disease Lecture Notes

Comprehensive vocabulary flashcards covering renal diseases, glomerular and tubular disorders, interstitial conditions, renal failure, and lithiasis based on the lecture transcript.

Glomerular Disease

A classification of renal disease where the glomerulus, a tuft of capillaries that filters blood, is the morphologic component initially affected.

Tubular Disease

A classification of renal disease that affects the urinary tubules in the kidneys, such as the proximal convoluted tubule and the ALoH.

Interstitial Disease

A classification of renal disease affecting the tissues or spaces that surround the tubules or the glomerulus.

Renal Threshold for Glucose

The blood glucose concentration range of $160-180\,mg/dL$; if glucose goes beyond this, it is excreted in the urine.

Primary Glomerular Disorders

Also called glomerulonephritides, these disorders specifically affect the kidney, which is often the only organ involved.

Secondary Glomerular Disorders

Systemic disorders that initially and principally involve other organs, with the glomeruli becoming involved as the systemic disease progresses.

Shield of Negativity

Electrical membrane charges that prevent proteins from being filtered by the glomerulus; disruption is a non-immunologic cause of glomerular damage such as in nephrotic syndrome.

Cellular Proliferation

A morphologic change in the glomerulus involving the growth of endothelial cells, mesangial cells, or podocytes, often due to irritation from immune complex deposition.

Leukocytic Infiltration

The activation of macrophage chemotactic activity that leads to the release of toxic substances which injure the glomerulus.

Sclerosis

The pathological hardening of tissues, such as the glomerulus, occurring due to the accumulation of amyloid or hyaline-like substances.

Circulating Immune Complexes

Antigen-antibody complexes created in response to endogenous or exogenous antigens that become trapped within the glomeruli and bind complement, causing injury.

Acute Post-streptococcal Glomerulonephritis (APGN)

Also known as Bright’s disease, a clinical disorder caused by S. pyogenes and characterized by the deposition of immune complexes on the glomerular membranes.

Dysmorphic RBCs

A key urinalysis finding for glomerular disorders that is most prominent in Acute Post-streptococcal Glomerulonephritis (APGN).

RBC Casts

The hallmark characteristic finding in the urinalysis of a patient with acute glomerulonephritis.

Rapidly Progressive (Crescentic) Glomerulonephritis (RPGN)

A disorder involving cellular proliferation of epithelial cells inside the Bowman’s capsule forming crescents, often caused by SLE and having a $90\%$ chance of progressing to end-stage renal failure.

Azotemia

A condition characterized by increased levels of blood nitrogen, urea, and creatinine in the circulation without observable symptoms.

Uremia

An increase in blood creatinine and urea where clinical symptoms are observed in the patient.

Goodpasture Syndrome

An autoimmune disease where anti-glomerular basement membrane antibody is deposited on the glomerular and alveolar membranes, leading to hemoptysis and dyspnea.

Wegener’s Granulomatosis

Also known as Polyangiitis, a condition where anti-neutrophilic cytoplasmic autoantibody (ANCA) binds to neutrophils in vascular walls, damaging small vessels in the lungs and glomerulus.

Henoch-Schoenlein Purpura (HSP)

Also known as IgA Vasculitis, an idiopathic disorder occurring in children following viral respiratory infections, characterized by a purpuric rash and joint pain.

IgA Nephropathy (Berger’s Disease)

The most common cause of chronic glomerulonephritis, involving the deposition of IgA aggregates on the glomerular membrane.

Membranous Glomerulonephritis

The most common cause of Nephrotic Syndrome in adults, characterized by thickening of the glomerular basement membrane due to IgG immune complex deposition.

Membranoproliferative Glomerulonephritis

Also referred to as Mesangiocapillary glomerulonephritis (MPGN), it involves cellular proliferation affecting the capillary walls or the glomerular basement membrane.

Waxy and Broad Casts

The primary indicator or marker found in urinalysis that signifies a chronic renal disorder rather than an acute one.

Nephrotic Syndrome

A group of syndromes characterized by massive loss of proteins ($>3.5\,g$) and lipids due to disruption of the podocyte barrier and the shield of negativity.

Podocytes

Cells with finger-like projections responsible for the shield of negativity in the kidney that prevents protein excretion.

Minimal Change Disease

Also known as lipoid nephrosis or nil disease, it involves podocyte disruption primarily in children following allergic reactions and responds well to corticosteroids.

Focal Segmental Glomerulosclerosis (FSGS)

A condition where scarring or sclerosis affects only segments of certain glomeruli, often associated with heroin abuse, analgesics, and AIDS.

Diabetic Nephropathy

Also named Kimmelstiel-Wilson Disease, it is the most common cause of End-Stage Renal Disease and involves deposition of glycosylated proteins on the glomerular basement membranes.

Alport Syndrome

A genetic disorder showing thinning of the glomerular basement membrane due to a deficiency in non-functional collagen IV.

Acute Tubular Necrosis

Damage to renal tubular cells caused by ischemia or toxic agents, characterized by the presence of $2$ or more RTE cells and dirty brown casts in urinalysis.

Fanconi Syndrome

A disorder involving a generalized defect in renal tubular reabsorption in the proximal convoluted tubule, often associated with cystinosis and Hartnup disease.

Uromodulin-associated kidney disease (UKD)

An inherited defect in the production of normal uromodulin by the renal tubules, which increases uric acid and causes gout.

Renal Glucosuria

A benign condition where blood glucose is normal but urine glucose is increased due to defective tubular reabsorption.

Neurogenic Diabetes Insipidus

A condition resulting from the failure of the hypothalamus to produce antidiuretic hormone (ADH).

Nephrogenic Diabetes Insipidus

A condition resulting from the inability of the renal tubules to respond to antidiuretic hormone (ADH).

Cystitis

An ascending bacterial infection of the urinary bladder (lower UTI) characterized by WBCs and bacteria in the urine but an absence of casts.

Acute Pyelonephritis

An upper UTI involving infection of the renal tubules and interstitium, characterized by the presence of WBC and Bacterial casts.

Vesicoureteral Reflux

A condition where urine from the urinary bladder flows back into the kidney, often due to abnormalities in the muscles of the bladder and ureters.

Acute Interstitial Nephritis

Also known as Drug-Induced Interstitial Nephritis, it is an allergic inflammation of the interstitium often caused by Penicillin, NSAIDs, or kidney allograft rejection.

Renal Tubular Acidosis

A disorder where tubules are unable to secrete adequate hydrogen ions, resulting in acidic blood and alkaline urine.

Isosthenuria

The loss of renal concentrating ability seen in renal failure where the glomerular filtration rate drops to $<25\,mL/min$.

Telescoped Sediment

The simultaneous appearance of elements of acute and chronic glomerulonephritis and nephrotic syndrome, such as RBC, granular, waxy, and broad casts.

Renal Lithiasis

Also known as renal calculi or kidney stones, which most commonly form in the calyces and pelvis of the kidney.

Calcium Oxalate

The most common composition of renal calculi, accounting for approximately $80\%$ of cases.

Triple Phosphate

A type of renal calculus accompanied by urea-splitting bacteria infections, forming branching staghorn shapes resembling deer antlers.

Extracorporeal Shockwave Lithotripsy (ESWL)

A non-invasive medical procedure that uses sound waves to break up kidney stones in vivo.