Term
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Definition
| Glomerulonephritis, ischemia, malignant hypertension |
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Term
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Definition
| Tubulointerstital inflammation, acute pyelonephritis, transplant rejection |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Advanced renal disease/chronic renal failure |
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Term
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Definition
| APSGN, RPGN, Bergers IgA, Alport syndrome |
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Term
| Both Nephritic and nephrotic |
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Definition
Diffuse proliferative glomerulonephritis (DPGN)
Membranoporliferative glomerulonephritis (MPGN) |
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Term
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Definition
Massive proteinuria >3.5 g/day (frothy), hyperlipidemia, fatty casts, edema
Assoc with thromboembolism and inc risk of infection
FSGS, Membranous nephropathy, minimal change disease, amyloidosis, diabetic glomerulonephropathy |
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Term
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Definition
LM- segmental sclerosis and hyalinosis
EM- effacement of foot processes (similar minimal change)
*Most common cause of nephrotic syndrome in adults
Assoc: HIV, heroin, massive obesity, interferon treatment, CKD due to congenital absence or removal |
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Term
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Definition
LM- diffuse capillary and GBM thickening
EM- *Spike and dome deposits in subepithelium
IF- granular
Assoc with drugs, infection, SLE, solid tumors |
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Term
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Definition
EM- foot process effacement
Selective loss of albumin (NOT globulins) caused by GBM poyanion loss
May be triggered by recent infection or an immune stimulus
Most common in children
*responds to corticosteroids |
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Term
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Definition
LM- congo red stain shows apple green birefringence
Assoc with MM, TB, RA |
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Term
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Definition
Type 1-Subendothelial IC deposits with granular IF; *tram tract appearance due to GBM splitting from mesangial growth
Assoc with HBV and HCV
Type 2- intramembrane IC deposits (dense deposits)
Can also present as nephritic syndrome
Assoc with C3 nephritic factor |
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Term
| Diabetic glomerulonephropathy |
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Definition
Nonenzymatic glycosylation of GBM, Inc permeability, thickening
NEG of efferent arterioles > Inc GFR, mesangial expansion
LM- mesangial expansion, GBM thickening, eosinophilic nodular glomerulosclerosis
*(Kimmelstiel Wilson lesion) |
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Term
| Acute Post strep glomerulonephritis |
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Definition
LM- enlarged and hyper cellular glomeruli, neutrophils; *Lumpy-bumpy appearance
EM- subepithelial immune complex humps
IF- granular appearance due to IgG, IgM and C3 deposition along GBM and mesangium
Peripheral and periorbital edema, dark urine, hypertension |
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Term
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Definition
LM and IF- crescents made of fibrin and plasma proteins (C3b) with glomerular parietal cells, monocytes and macrophages
*Goodpastures (T2 HS Rxn, linear IF, Ab to GBM - hematuria and hemptysis)
Wegeners - cANCA
Microscopic polyangiitis - pANCA |
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Term
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Definition
Due to SLE or MPGN "Wire lupus"
LM- wire looping of capillaries
EM- subendothelial IgG and C3 deposits
*Most common cause of death in SLE |
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Term
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Definition
Related to Henoch-Schonlein purpura
LM- mesangial proliferation
IF- IgA based IC deposits in mesangium
Often presents with a URI or acute gastroenteritis |
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Term
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Definition
Mutation in type 4 collagen > split BM
X linked
Glomerulonephritis, deafness and less commonly, eye problems |
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Term
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Definition
80% - most common
CaPO4 precipitates at high pH
Ca oxalate precipitates at low pH
Radiopaque
Oxalate crystals can result from ethylene glycol or Vit C abuse
Tx: thiazides and citrate |
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Term
| Ammonium magnesium phosphate kidney stone |
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Definition
15% - second most common
Inc pH
Radiopaque
Infection with urease pos bugs (Proteus, Staph, Klebsiella)
Hydrolyze urea to ammonia > urine alkalinization
*staghorn calculi |
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Term
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Definition
Dec pH, radiolucent
Visible only on CT and US (not XR)
Often seen in diseases with inc cell turnover (leukemia)
Tx: alkalinize the urine |
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Term
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Definition
Back up of urine into the kidneys
Dilation of renal pelvis and calyces prox to obstruction
Parenchymal thinning in chronic, severe cases |
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Term
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Definition
Dec pH, radiopaque
Most often secondary to cystinuria
Hexagonal crystals
Tx with alkalization of urine |
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Term
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Definition
Originates from proximal tubule cells > polygonal clear cells
Filled with lipids and carbohydrates
Men 50-70, inc with obesity and smoking
Invades renal vein then IVC and spreads hematogenously
Mets to liver and bone
*Gene deletion on chromasome 3, VHL |
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Term
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Definition
Most common renal malignancy of early childhood
Contains embryonic glomerular structures
Huge palpable flank mass and/or hematuria
Deletion of TSG WT1 on c11
May be part of Beckwith-Weidman syndrome or WAGR complex |
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Term
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Definition
| Wilms tumors, Aniridia, Genitourinary malformation and MR |
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Term
| Transitional cell carcinoma |
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Definition
Most common tumor of the urinary tract system
Painless hematuria (no casts) suggests bladder cancer
Assoc: Phenacetin, Smoking, Aniline dyes and cyclophosphamide |
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Term
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Definition
Affects cortex with sparing of glomeruli
Fever, CVA tenderness, nausea and vomiting
White cell casts in urine are classic |
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Term
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Definition
Requires predisposition to infection, like vesicourteral reflux, or chronically obstructing kidney stones
Coarse, asymmetric corticomeduallry scarring, blunted calyces
*tubules can contain eos casts (thyroidization) |
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Term
| Drug induced interstitial nephritis |
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Definition
Acute interstitial renal inflammation
Pyuria and azotemia (eosinophils)
Drugs act as hapetens, inducing hypersensitivity
1-2 weeks post drug administration
*diuretics, penicillin, sulfonamides, rifampin, nsaids (months)
Fever, rash, hematuria and CVA tenderness |
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Term
| Diffuse cortical necrosis |
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Definition
Acute generalized cortical infarction of both kidneys
Likely due to vasospasm and DIC
*obstetric catastrophies and septic shock |
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Term
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Definition
Most common cause of intrinsic renal failure
1. Inciting event
2. Maintenance phase- oliguric, lasts 1-3 weeks, hyperkalemia
3. Recovery phase- polyuric; BUN and serum createnine fall, risk of hypokalemia
Renal ischemia, crush injury, drugs, toxins |
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Term
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Definition
Sloughing of renal papillae
Gross hematuria and proteinuria
Recent infection or immune stimulus
Assoc: DM, acute pyelo, Chronic phenacetin use, SCA |
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Term
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Definition
In normal nephron, BUN is reabsorbed but Cr is not
ARF: abrupt decline in renal function with inc Cr and Inc BUN over a period of several days |
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Term
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Definition
Dec RBF, leads to dec GFR
Na, H2O, and urea are retained to conserve volume
Urine osm: >500
Urine Na: <20
FeNa: <1%
Serum BUN/Cr: > 20 (urea resorption) |
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Term
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Definition
ATN, Acute glomerulonephritis, toxins, or ischemia
Patchy necrosis leads to debris obstructing tubules and fluid back flow across necrotic tubule > dec GFR
Urine has epithelial/granular casts
Urine Osm: <350
Urine Na: >40
FeNa: >2%
Serum BUN/Cr: < 15 (resorption is impaired) |
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Term
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Definition
Outflow obstruction
Develops only with bilateral obstruction
Urine Osm: <350
Urine Na: >40
FeNa: >2%
Serum BUN/Cr: >15 |
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Term
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Definition
Inc BUN and Inc Cr
Nausea, anorexia, pericarditis, asterixis, encephalopathy, platelet dysfunction |
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Term
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Definition
Failure of Vit D hydroxylation, hypocalcemia, and hyperphosphatemia > secondary hyperparathyroidism
Hyperphosphatemia > dec serum Ca by causing tissue calcs
Sub periosteum thinning of bones |
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Term
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Definition
Bilateral cysts that destroy the parenchyma
AD mutation in PKD1 or PKD2
Death from chronic kidney disease or HTN
Assoc: berry aneurysm, MV prolapse, benign hepatic cysts |
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Term
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Definition
Infntile presentation in parenchyma
Congenital hepatic fibrosis
Significant renal failure in utero can lead to Potter's syndrome
HTN, portal HTN and progressive renal insufficiency |
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Term
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Definition
Inherited causing tubuloinsterstital fibrosis and progressive renal insufficiency with inability to concentrate urine
Shrunken kidneys on US, poor prognosis |
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Term
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Definition
Osmotic diuretic in PCT; increases tubular fluid osmolarity, producing inc urine flow and dec IOP/ICP
Use: drug overdose, ICP/IOP increase
T- pulmonary edema, dehydration, CI'd in anuria, CHF |
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Term
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Definition
CA inhibitor
Self limited NaHCO3 diuresis and reduction in HCO3 store
Use- glaucoma, metabolic alkalosis, altitude sickness, pseudo tumor cerebra
Tox- Hyperchloremic metabolic acidosis, NH3 tox, sulfa allergy |
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Term
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Definition
Loop diuretic, works at thick ascending limb of LOH
Inhibits Na/K/Cl transporter. Abolishes hypertonicity of medulla
Stimulates PGE release (vasodilatory), inhibited by NSAIDs
Loops lose calcium
Use- edematous states, HTN, hypercalcuria
T- Ototox, Hypokalemia, dehydration, sulfa allergy, nephritis, gout |
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Term
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Definition
Same action as Furosemide (loop)
Use- diuresis in patients allergic to sulfa
T- similar to furosemide. Never use or gout |
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Term
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Definition
Inhibits NaCl reabsorption in early distal tubule, reducing diluting capacity of nephron
Dec Ca excretion
Use- HTN, CHF, hypercalcuria, nephrogenic diabetes insipidus
Tox- hypokalemic metabolic acidosis, hyperglycemia, hyperlipidemia, hyperuricemia, and hypercalcemia |
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Term
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Definition
Spironolactone, eplerenone,triamterene, Amiloride
Works at CD
Spir and Ep are competitive aldosterone R antagonists
Triam and Amil act by blocking Na channels in CCT
Use- hyperaldosteronism, K depletion, CHF
Hyperkalemia
Tox- Hyperkalemia, endocrine effects (gynecomastia) |
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Term
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Definition
Acidemia- CA blockers, K sparing,
Alkalemia- Loops and thiazides |
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Term
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Definition
Captopril, lisinopril, enalapril
Inhibit ACE > dec GFR by preventing constriction at eff arteriole
Renin levels increase due to loss of feedback
Prevents Inactivation of bradykinin, a potent vasodilator
Use- HTN, CHF, proteinuria, diabetic renal disease
*prevents heart remodeling from CHF
T- cough, angioedema, teratogen, Cr increase, Hyperkalemia, Hypotension
*avoid in bilateral renal artery stenosis because ACEI will further decrease GFR |
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