Ch 14.pdf

Publish in

Documents

14 views

Please download to get full document.

View again

of 2
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Share
Description
Path
Tags
Transcript
  Chapter 14 Renal Diseases Glomerular Disease: -- Glomerulonephritis (GN) is one of the most common reasons for renal failure. --GN is caused by a variety of primary and secondary glomerular diseases. We are concerned  with the primary diseases. See Table 14-1. -- Immune rxns underlie most causes of primary GN. 2 forms Ab mediated injury established: a. Type III HS, immune complex disease from circulating immune cmplxs, Fig.14-3-A,  and  b. Injury from Ab reacting with in-situ glomerular antigens. Fig. 14-3-B. Clinical Manifestations of Glomerular Diseases  ( Fig. 14-1 ) Nephrotic syndrome: heavy proteinuria, hypoalbuminemia, severe edema, hyperlipidemia, lipiduria 2 Examples— 1. Lipoid Nephrosis: 2. Membranous glomerulonephritis: Nephritic syndrome: hematuria, oliguria, mild proteinuria, azotemia, edema, hypertension – Example— acute post-Streptococcal GN: Chronic GN:  This is the end result of several glomerular diseases. A non-specific end point. Results in ... 30-50% of dialysis or transplantation. 20-25% occur w/o previous history of renal disease. TUBULAR DISEASES & INTERSTITIAL DISEASES    Acute pyelonephritis   Most retrograde gram (-) organisms i.e. E. coli . May occur from catheters.  Vesicoureteral reflux in children. Causes : obstruction, instrumentation, reflux, pregnancy. U p to age 40, more common in females . Ascending vs . hematogenous infections. ( Fig. 14-14)   Chronic pyelonephritis & Reflux Nephropathy    Obstruction and chronic reflux . One or both kidneys  may be involved. Deep scars . First sign frequently hypertension (benign nephrosclerosis). Drug-Induced Interstitial Nephritis (Acute)  oliguria or a rise in serum creatinine levels common signs. Associated with synthetic antibiotics, NSAIDs. May be both a type I (IgE) and a type IV response  Analgesic nephropathy (Chronic)   papillary necrosis . NSAIDs (asp, phenacetin, acetaminophen, caffeine combos)  Acute Tubular Necrosis   A lot of causes - Mostly REVERSIBLE . MC cause of acute renal failure.  BLOOD VESSEL DISEASES: Talking about 2 renal blood vessel diseases associated with systemic hypertension. 1. Benign Nephrosclerosis (hyaline arteriolosclerosis)-- Common over age 60. The term refers to renal vascular disease seen in benign (common) hypertension. Vascular lesions are called hyaline arteriosclerosis. 2. Malignant Nephrosclerosis--  A severe form of nephrosclerosis seen in malignant hypertension. The vessels of the kidneys show fibrinoid necrosis and hyperplastic arteriosclerosis. CYSTIC DISEASES: Common renal lesions that may lead to renal failure. 1. Simple Cysts-- Most asymptomatic. Dialysis may cause them, too. 2. (Adult) Polycystic Disease-- Asymptomatic until over 40. Causes 10% of renal failure cases. URINARY OBSTRUCTIONS:   Renal Stones (Urolithiasis) 75% calcium oxalate or calcium oxalate mixtures. Causes are from supersaturation of the stones constituents in the urine. In 10% of cases, hypercalcemia, from whatever the cause, results in hyper calciurea. TUMORS: Renal Cell Carcinoma--  8 0% of all kidney cancers . Hematuria common presenting sign (~50%) Clear Cell - most common type --- 70-80% of renal cell carcinomas.  Wilms Tumor  Some genetic infl. but most are sporadic. 3 rd  most common organ cancer in children .
Related Search

Previous Document

ETHICS_7.PPT

Next Document

Ch 13.pdf

We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks