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Renal Pathology
Glomerulonephritis, Acute RF and Chronic RF
| Sign/Symptom | Pathology |
|---|---|
| Smoky haematuria, proteinuria, hypertension, some kidney impairment and some oedema | Nephritic Syndrome |
| Heavy proteinuria, hypoalbuminaemia, oedema, hyperlipidaemia | Nephrotic Syndrome |
| Nephrotic syndrome with a bland urine sediment | Minimal change GN, diabetic nephropathy or amyloid deposition |
| Renal failure occuring over a few months with active urine sediment | Rapidly progressive GN |
| The most common cause of nephritic syndrome in children. Is due to an immune-directed circulating factor that causes the glomeruli to leak. Bland urine sediment and normal glomeruli under light microscopy | Minimal Change Disease |
| Nephrotic syndrome in adults due to a circulating immune-directed permeability factor. Sclerosis occurs in some parts of some glomuerli. Treatment with prednisolone usually doesn't work | Focal Segmental Glomerulonephritis |
| The most common cause of nephrotic syndrome in adults. It can be caused by antibodies, systemic lupus erythematosus and drugs. | Membranous Glomerulonephritis |
| One of the most common causes of GN. Can occur at the same time as pharyngitis. | IgA Glomerulonephritis |
| A nephritic syndrome that occurs after an infection with certain strains of Strep, usually in children. Proliferation with immune complex deposition. If the antigen is removed, they get better. | Post-infectious Glomerulonephritis |
| A systemic autoimmune disease that usually occurs in young women and presents with a butterfly rash. | Lupus Nephritis |
| Autoimmunity with autoantibodies to neutrophil proteins causing vasculitis in the lungs and kidneys. The neutrophils damage the basement membranes and cause severe necrosis. | ANCA-associated Glomerulonephritis |
| Autoimmunity with autoantibodies to a structural collagen in the basement membranes of the kidneys and lungs. Results in cresent formation and rapidly progressive GN with lung haemorrhage. | Anti-Glomerular Basement Membrane Glomerulonephritis (GOODPASTURE'S DISEASE) |
| Renal failure caused by shock and renal artery stenosis (TRIPLE WHAMMY) | Pre-renal acute renal failure |
| Renal failure caused by bladder outflow obstruction, urethral stricture, ureteric obstruction or congential PUJ obstruction | Post-renal acute renal failure |
| A tubulointerstitial, renal cause of ARF. It can be either toxic or ischaemic (from unresolved pre-renal ARF). Characterised by a bland urinary sediment and oliguria. | Acute tubular necrosis |
| A tubulointerstitial cause of renal ARF. An inflammatory reaction that is usually in response to drugs (eg. antimicrobials, NSAIDs, diuretics). Eosinophil infiltration causes renal impairment. | Acute or Chronic Interstitial Nephritis |
| A glomerular cause of renal ARF that is associated with glomerulosclerosis and arteriosclerosis. | Diabetic nephropathy |
| A complicating factor of vascular, renal ARF. | Hypertension |
| A vascular cause of renal ARF characterised by the inflammation and necrosis of blood vessels by 'rogue' immune cells | Polyarteritis |
| A vascular cause of renal ARF that is due to cholesterol release from an atheromatous plaque. There are increased inflammatory markers. | Cholesterol athero-embolism (CE) |
| Increases the tone of the afferent (lesser) and efferent (greater) arterioles. | Angiotensin II |
| Maintains normal afferent tone to prevent it from constricting fully. | Prostacyclins |
| 50% or more of kidney function | Normal creatinine |
| Less than 50% of kidney function | Elevated creatinine |
| 15% residual GFR (urea >40mmol/L) | Uraemia |
| <10% residual GFR | End-stage renal failure |
| The most common cause of chronic renal failure in Australia. | Diabetic nephropathy |
| Can be caused by ANCA glomerulonephritis, anti-glomerular basement membrane nephritis or systemic lupus erythematosus. Presents as crescenteric glomerulonephritis. | Rapidly progressive glomerulonephritis |
| Most common cause of UTIs | E.Coli - gram negative bacilli |
| Factor that increases risk of calculi formation | Urease - staph, proteus, pseudomonas |
| Antibiotic used for UTIs | Trimethoprim (NEVER amoxicillin)for 3-5 days (uncomplicated) or 10-14 days (pyelonephritis) |
| Investigation for UTI in males, children or pyelonephritis | Renal tract ultrasound |
| Investigation for first time UTI in female | None |
| Treatment for recurrent UTIs | Prophylactic or intermittent antibiotics |
| Recurrent UTIs in men | Chronic prostatitis |
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Epoot
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