the four types of renal disease

caused by immune mediated

caused by toxic or infectious substance

caused by reduction in renal perfusion

systemic diseases that initially and principally involve other organs but also affect kidneys

specifically affect kidneys, often only organ involved; several different types

increased numbers of capillary endothelial, mesangial, and epithelial cells in glomerular tuft

neutrophils and macrophages attracted by a local chemotactic response

any process that results in enlargement of basement membrane immune complexes and diabetes

accumulation of homogenous eosinophilic extracellular material

clinical features of glomerular diseases

nephrotic syndrome clinical features

types of glomerulonephritis

commonly caused by streptococcal infection occurring within 1-2 weeks of infection of throat or skin; caused by certain strains of group A beta hemolytic strep that contain M protein

caused by deposition of IgA in glomerular mesangium; 1-2 days after mucosal infection of respiratory, GI or urinary tract from bacteria and/or viruses

autoimmune disorder with immune complex deposits and complement activation

carbohydrate metabolism disorder that leads to glomerular syndrome, hypertension, susceptibility to pyelonephritis

systemic disease involving many organs; characterized by deposits of a pathologic protein substance; leads to proteinuria and nephrotic syndrome

includes ischemic and toxic

seen in sepsis shock and trauma

from exogenous or endogenous nephrotoxins

Fanconi's syndrome, cystinosis and cystinuria, renal glycosuria, renal phosphoturia, and renal tubular acidosis

any condition that presents with a generalized loss of proximal tubular function

inherited disorders that cause renal tubular dysfunction

excessive glucose excretion despite normal blood glucose levels

inability of distal tubules to reabsorb inorganic phosphorus

inability of tubules to secrete adequate hydrogen ions despite normal GFR

casts commonly seen

casts not common, usually leukocyturia and bacteruria

bacterial infection that involves renal tubules, interstitial and the renal pelvis; caused from ascending UTI infection from gram negative organism

persistent inflammation of renal tissue causes permanent scarring of renal calyces and renal pelvis

any immune response in the interstitial of the kidney commonly caused by kidney rejection

most commonly caused by Candida species, normal flora in GI tract and vagina

sudden decrease in glomerular filtration rate, azotemia, and oliguria; high mortality rate; prerenal or post renal; functional abnormality but no apparent cellular changes

progressive loss of renal function; due to hypertrophy of remaining healthy nephrons; not clinically recognizable until 80-85% of renal function is lost; azotemia, acid base imbalance, abnormal calcium and phosphate metabolism; fixed specific gravity of 1.010, proteinuria, hematuria, and presence of casts (waxy and broad)

aggregates of mineral salts in a matrix of proteins and lipids; 75% contain calcium

four factors influencing calculi formation

must be eliminated from the body and is done through the kidneys

an imbalance of urea in the body

inborn errors of indicators of metabolism

induced by severe liver disease or from renal tubular dysfunction

inherited disease; cystine is deposited throughout the body and accumulates causing damage and disrupting cellular functions

inherited disorder; nephrons are unable to reabsorb amino acids and excrete large amounts of cystine and other amino acids

rare inherited disease in which branched chain amino acids (leucine, isoleucine, and valine) accumulate in the blood, CSF, and urine; has distinctive caramelized sugar odor; can lead to mental impairment or spasticity in infants if not treated

inherited disease characterized by increased urinary excretion of a ketone acid; can lead to severe mental impairment; mousy or musty odor of urine, sweat and breath; also have decreased skin pigmentation; all infants screened

amino acid metabolism disorders

problems with glucose metabolism; chronic hyperglycemia and glycosuria; glomerular damage and chronic renal failure

inherited disorder in which an enzyme in the galactose metabolic pathway is deficient or defective; type 1 GALT most common form; screened for in newborns and tested for with reducing substances tablet test

decreased ADH hormone or nephrons are resistant to ADH; results in polyuria; unable to produce concentrated urine even when fluids are restricted

hereditary defects of the heme synthesis pathway; increased porphyrins and porphyrin precursors in blood and urine; turns urine reddish color