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Questions and Answers
What is the primary cause of chronic pyelonephritis?
What is the primary cause of chronic pyelonephritis?
What is a common clinical manifestation of chronic pyelonephritis?
What is a common clinical manifestation of chronic pyelonephritis?
What is a complication of chronic pyelonephritis?
What is a complication of chronic pyelonephritis?
What is the primary role of the kidney in renal osteodystrophy?
What is the primary role of the kidney in renal osteodystrophy?
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What is a characteristic of low bone turnover of osteodystrophy?
What is a characteristic of low bone turnover of osteodystrophy?
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What is a common symptom of renal osteodystrophy?
What is a common symptom of renal osteodystrophy?
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What is a consequence of impaired kidney function in renal osteodystrophy?
What is a consequence of impaired kidney function in renal osteodystrophy?
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What is the effect of chronic pyelonephritis on renal function?
What is the effect of chronic pyelonephritis on renal function?
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What is a common finding in chronic pyelonephritis?
What is a common finding in chronic pyelonephritis?
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What is a consequence of reflux in chronic pyelonephritis?
What is a consequence of reflux in chronic pyelonephritis?
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What is the primary function of parathyroid hormone in maintaining stable calcium levels?
What is the primary function of parathyroid hormone in maintaining stable calcium levels?
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What is the primary treatment for renal osteodystrophy?
What is the primary treatment for renal osteodystrophy?
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What is the most common type of azotemia?
What is the most common type of azotemia?
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What is the primary cause of acute tubular necrosis?
What is the primary cause of acute tubular necrosis?
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What is the primary indicator of acute kidney injury?
What is the primary indicator of acute kidney injury?
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What is the primary cause of glomerulonephritis?
What is the primary cause of glomerulonephritis?
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What is the primary sign of acute glomerulonephritis?
What is the primary sign of acute glomerulonephritis?
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What is the primary risk factor for developing Wilms' tumor?
What is the primary risk factor for developing Wilms' tumor?
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What is the primary treatment for renal cell carcinoma?
What is the primary treatment for renal cell carcinoma?
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What is the primary function of calcitriol in calcium absorption?
What is the primary function of calcitriol in calcium absorption?
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Study Notes
Chronic Pyelonephritis
- Characterized by scarring and deformation of renal calyces and pelvis
- Caused by bacterial infection superimposed on obstructive abnormalities or vesicoureteral reflux
- Occurs due to recurrent inflammation and scarring
- Reflux is the most common cause
- Clinical manifestations may include:
- Chills, high fever, and aches/tenderness of the flank and low back
- Urinary tract symptoms such as dysuria and frequency
- Recurrent UTIs
- Loss of tubular function and ability to concentrate urine
- Polyuria and nocturia
- Mild proteinuria
- Severe hypertension (progresses disease)
Reno Osteodystrophy
- Occurs in adults and children with chronic kidney disease
- Results from changes in mineral levels and hormones due to impaired kidney function
- Characterized by low bone turnover, decrease of osteoblasts, and low or reduced number of osteoclasts
- May cause bone tenderness, muscle weakness, and bone fractures
- Kidney roles in renal osteodystrophy:
- Decrease calcium levels
- Increase phosphorus levels
- Increase parathyroid hormone (PTH)
- Activate vitamin D to produce calcitriol, which aids in calcium absorption
- Treatment involves:
- Treating hyperphosphatemia and hypocalcemia
- Vitamin D to increase calcium levels
- Phosphate binding antacids
Prerenal Azotemia
- Most common type of azotemia
- Caused by accumulation of nitrogenous waste in the blood and a decrease in GFR
- Results in excretion of nitrogenous waste, reduction of fluid and electrolyte balance
- Seen in glomerular disorders
- Occurs when there is not enough blood flow to the kidney
- Causes include:
- Blood loss
- Dehydration
- Heart failure
- Liver failure
- Certain medications
Acute Tubular Necrosis
- Most common cause of intrinsic failure
- Occurs secondary to ischemic or toxic injury to renal tubules
- Occurs when arteriole pressure (MAP) is decreased
- Afferent and efferent arterioles lose their regulatory process with hypoperfusion
- Sympathetic stimulation and angiotensin II cause severe vasoconstriction
- Hypoxia leads to cellular damage, epithelial cells slough into the lumen, and tubular pressure increases
- Tubular injury and necrosis cause a leak of glomerular filtrate
- The tubular epithelial is disrupted, leading to increased BUN, creatinine, and potassium levels
Extreme Proteinuria
- Also known as nephrotic range proteinuria
- Defined as >3000 mg (3g) protein per day
- Associated with conditions such as nephrotic syndrome and glomerulonephritis
- Lab considerations include:
- Urine dipstick test
- 24-hour urine collection
- Albumin to creatinine ratio (ACR)
Glomerulonephritis
- Acute poststreptococcal Glomerulonephritis (PSGN) is the most common form
- Occurs 7-12 days following an infection (usually throat or skin infection with group A hemolytic strep)
- Caused by antigen/antibody complex formation and complement deposition on the glomerulus
- Signs and symptoms include:
- Sudden hematuria
- Edema
- Hypertension
- Renal insufficiency
- In children, the prognosis is favorable, with 95% recovering without renal damage
- In adults, only 60% recover favorably, with the remainder developing permanent kidney damage
Renal Cell Carcinoma
- Two major groups of renal neoplasms:
- Embryonic kidney tumors (e.g., Wilms' tumor)
- Renal cell carcinoma (accounts for 80-90% of kidney tumors)
- Lack of warning signs
- Resistant to chemo/radiation
- Diagnosed by ultrasound or CT scan
- Treatment involves surgical resection
- Five-year survival rate is 90% before metastasis
Syndrome of Inappropriate ADH (SIADH)
- Caused by increased ADH release
- Increased reabsorption of water in the collecting tube
- Decreased water in the filtrate
- Increased urinary output (as kidney absorbs more water)
- Concentrated urine (increased specific gravity, can be > 1.020)
- Clinically:
- Patient appears edematous
- Decreased sodium
- Increased weight gain
- Can be seen in patients with CNS disease
- Increased ADH when patients are in pain (e.g., surgery, asphyxia, pneumothorax)
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Description
Test your knowledge on chronic pyelonephritis, a type of bacterial infection that affects the kidneys. Learn about its causes, symptoms, and effects on the renal system.
