Kidney diseases

  1. What are 4 types of glomerulonephritis most commonly associated with nephritic syndrome? (descending order)
    • 1. Post-streptococcal glomerulonephritis
    • 2. Crescentic glomerulonephritis
    • 3. IgA nephropathy
    • 4. Membranoproliferative glomerulonephritis
  2. What are 3 things we need for know before performing a renal biopsy?
    • 1. Bleeding time (platelet count, PT) - patients with uraemia may have prolonged bleeding
    • 2. Blood pressure
    • 3. Anatomy of kidneys (U/S required)
  3. Describe the pathogenesis of post-streptococcal glomerulonephritis.
    • Antigens deposit in glomerular capillaries, commonly reside between glomerular membrane and podocytes
    • Antibodies bind to antigens and form immune complexes
    • Complement is activated (C3a & C5a) and they are chemotactic for leukocytes
    • C3a & C5a cause histamine release from mast cells, leading to increased vascular permeability
    • C5b-C9 complex directly damages glomerular membrane
    • Intercellular adhesion molecules causes adhesion of cells to endothelium
    • Podocytes are damaged and retract
    • Blood and protein enters Bowman's space
  4. Name 5 types of glomerulonephritis associated with nephrotic syndrome.
    • 1. Membranous glomerulonephritis
    • 2. Focal segmental glomerulonephritis
    • 3. Minimal change disease
    • 4. Membranoproliferative glomerulonephritis
    • 5. Diabetic glomerosclerosis
  5. Name 3 clinical problems associated with proteinuria.
    • Hypercoagulability -- e.g. renal thrombus
    • Increased infection risk
    • CVD
  6. Name 4 common causes of membranous glomerulonephritis.
    • SLE
    • Drugs e.g. gold, NSAIDS, captopril
    • Infections e.g. hep B, malaria
    • Cancers e.g. carcinoma, melanoma, leukaemia
  7. Name 2 types of glomerulonephritis associated with asymptomatic urinary abnormalities.
    • IgA nephropathy - Berger's disease
    • Thin basement membrane disease
  8. Characteristics of the nephrotic syndrome? - 4
    • Heavy proteinuria (at least (3.5 grams per day) with hypoproteinaemia
    • Generalised oedema
    • Increased blood lipids, particularly cholesterol
    • Presence of lipids in the urine
  9. Characteristics of the nephritic syndrome?
    • GRF impaired
    • Patients feel generally ill with facial oedema, most often noticed early in the morning
    • Haematuria (microscopic)
    • Hypertension
  10. Define oliguria.
    Excretion of less than 400ml of urine per day
  11. Name the common causes of acute renal failure (3 categories).
    • Prerenal: hypovolemia, renal a. stenosis, ineffective blood delivery e.g. CHF
    • Intra-renal: vasculitis, malignant htn, acute tubular necrosis (ischemic,nephrotoxic)
    • Postrenal: bilateral ureteric obstruction, bladder-outlet obstruction
  12. Name 3 main causes of chronic kidney failure in Australia (descending order)
    • Diabetic nephropathy
    • Glomerulonephritis
    • Hypertension

    • Reflux nephropathy
    • Polycystic kidney disease
  13. Describe the pathogenesis of oedema, hypercholesterolemia, hypoalbuminemia and infections in nephrotic syndrome.
    • Oedema: low oncotic pressure due to hypoalbuminaemia and retention of salt/water by kidneys
    • Hypercholesterolemia: liver overproducing lipoproteins due to fall in oncotic pressure
    • Hypoalbuminemia: urinary protein loss, increased catabolism of filtered albumin (proximal tubule), redistribution of albumin within body
    • Infections: urinary loss of immunoglobulins and defect in complement cascade
  14. Name 6 contraindincations for renal biopsy.
    • PKD
    • Solitary kidney
    • CRF
    • Active urinary infection
    • Severe hypertension
    • Coagulation disorders
Card Set
Kidney diseases
glomerulonephritis, renal failure