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Final
Kidney Pathology
| Question | Answer |
|---|---|
| Simple Renal Cysts | Acquired May be single, multiple, unilateral, or bilateral Develop in renal parenchyma |
| Acquired Cystic Kidney Disease | Acquired lesions, probably from obstructed ducts or tubules Found in native kidneys of patients with renal failure who need to undergo renal transplant or dialysis |
| Types of Simple Renal Cysts | Infected Hemorrhagic Calcified Septated Parapelvic - not a true cyst |
| Polycystic Kidney Disease | Inherited condition in which normal renal tissue is replaced by cysts |
| Polycystic Kidney Disease Types | Autosomal-recessive polycystic kidney disease (ARPKD) Autosomal-dominant polycystic kidney disease (ADPKD) |
| Autosomal-recessive polycystic kidney disease (ARPKD) | Infantile polycystic disease Rare disorder Chromosome 6 |
| Autosomal-dominant polycystic kidney disease (ADPKD) | Adult autosomal-dominant form Common disorder Severity varies depending upon the genotype |
| Multicystic Dysplastic Kidney | Not inherited Usually unilateral Due to obstruction early in life |
| Renal Calculi | Stones may be large or small Usually originate in kidney May pass into ureter and bladder |
| Staghorn Calculus | Large, odd shaped stone in the renal pelvis Causes infection Must be surgically removed |
| Obstruction | UPJ ureteropelvic junction obstruction Hydronephrosis |
| Hydronephrosis | Pyelonephrosis Results from obstruction of the urinary system Commonly occurs at UPJ, Bladder outlet |
| Mild hydronephrosis | separation of calyces |
| Moderate hydronephrosis | dilated calyces and pelvis |
| Severe hydronephrosis | Cortical involvement |
| 3 kinds of Infection | Abscess Pyelonephritis Pyonephrosis |
| Abscess | Pus containing cavity surrounded by renal tissue May also contain debris, necrotic tissue, or gas Symptoms include pain, fever, chills, elevated WBC count |
| Pyelonephritis | Inflammation of the kidney Acute or chronic Pyogenic bacteria invade renal tissue. |
| Acute pyelonephritis | Swollen and edematous bilateral or unilateral |
| Chronic pyelonephritis | Atrophic with decreased renal parenchyma |
| Pyonephrosis | Chronic infection in an obstructed system Caused by urine stasis and secondary infection Collecting system becomes filled with thick pus |
| Hematoma | An extravascular collection of blood Usually from trauma or surgery Vary in size and shape Get smaller with time |
| Nutcracker Syndrome | a vascular compression disorder and refers to the compression of the left renal vein between the superior mesenteric artery (SMA) and aorta |
| Most common symptoms of RNS include | pelvic pain, flank pain, hematuria) varicocele in men, and/or ovarian vein syndrome in women (when dilated ovarian veins cause chronic obstruction of the ureter) |
| Infarct | Acute occlusion of either the main renal artery or a major intrarenal branch |
| Causes of infarct | Trauma Drug abuse Vasculitis Bacterial endocarditis Myocardial infarction (MI) |
| Renovascular Hypertension | Result of narrowing of one or both renal arteries Causes elevated blood pressure |
| Renovascular hypertension types | Intrarenal - involves intrarenal arteries Extrarenal - involves obstruction or compression of the extrarenal arteries |
| Benign Diseases | Nephrocalcinosis Chronic renal failure |
| Nephrocalcinosis | Precipitation of calcium phosphate in the renal tubules May cause renal insufficiency |
| Chronic Renal Failure | Loss of kidney function resulting from intrinsic. Primary causes: Glomerulonephritis Renal Parenchymal Diseases |
| Sonographic findings of chronic renal failure | Loss of normal echo pattern |
| Benign Neoplasms | Angiomyolipoma Lipoma Fibroma Adenoma |
| Angiomyolipoma | Hamartoma Usually asymptomatic Very echogenic mass |
| Lipoma | Tumor composed of fatty tissue |
| Fibroma | Fibrous tumor |
| Adenoma | Composed of glandular epithelium |
| Malignant Neoplasms | Adenocarcinoma Nephroblastoma |
| Adenocarcinoma | Most common malignant tumor of the kidney Originates from renal tubular epithelial cells Metastasis to: Lung Bone Brain Liver Adrenal |
| Wilms’ Tumor | Nephroblastoma Usually occurs below the age of 5 Metastasizes Lungs Liver Lymph nodes Bone |
| Metastases | Single or multiple lesions From: Lung Breast Stomach Other kidney Myeloma |
| Renal Transplants | Donors can be living relatives or cadavers Renal transplant is placed in the pelvis along the iliopsoas margin ALWAYS scan a renal transplant with a full bladder |
| Renal Transplant procedure | The donor’s left kidney is removed, rotated, and placed in the receipent’s right iliac fossa The renal artery is attached to the external iliac artery The ureter is inserted into the bladder |
| Sonography and Transplants | 24 to 48 hours after the surgery a baseline scan is performed Monitor transplants by: Ruling out hydronephrosis Looking for fluid collections such as urinoma, lymphocele, hematoma, and abscess |
| Signs of Rejections | Enlarged pyramids with decreased echogenicity Hyperechoic cortex Dense area of renal tissue Distorted renal outline Hypoechoic areas spread throughout the kidney |
| Reasons for Rejection | Acute Tubular Necrosis Occlusion of renal artery Infection Graft rupture or rejection |
| Acute Tubular Necrosis | Common cause of transplant failure Cannot be seen sonographically Patient has elevated lab reports Low urine output |
| Graft Rupture or Rejection | Symptoms: Sudden pain No urine output Shock due to blood loss |
Created by:
portn6579
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