Pathophysiology PATN 201: Kidney Disorders

Study Notes

Azotemia: Increased blood urea nitrogen (BUN) and creatinine levels.
Uremia: Azotemia accompanied by additional complications.
Acute Renal Failure: Characterized by oliguria (reduced urine output).
Chronic Renal Failure: Long-standing uremia leading to permanent kidney impairment.

Glomerular Diseases: Involves conditions directly affecting the glomeruli.
Tubular Diseases: Conditions impacting the renal tubules.
Congenital Anomalies: Genetic deformities affecting kidney structure/function.
Vascular Diseases: Disorders related to kidney blood vessels.
Kidney Stones: Formation of calculi within the kidney.
Neoplasia: Overgrowth of kidney tissues leading to tumors.

Nephrotic Syndrome:
- Characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia.
- Common causes include diabetes in adults and minimal change disease in children.
- Good prognosis associated with early identification and management.
Nephritic Syndrome:
- Includes hematuria, oliguria, azotemia, and hypertension.
- Typically caused by post-infectious glomerulonephritis or IgA nephropathy.
- Characterized by inflammatory changes and glomerular proliferation.

Typically occurs following streptococcal throat infections in children.
Involves immune complex deposition leading to hypercellular glomeruli and subepithelial humps.

Marked by diffuse loss of podocyte foot processes, vacuolation, and microvilli appearance.
Common in children, often with a favorable prognosis.

Caused by autoimmune reactions to unknown renal antigens.
Marked by immune complex deposition leading to thickened glomerular basement membrane (GBM).

Pyelonephritis:
- Invasive kidney infection commonly ascending from UTIs.
- Symptoms include fever and flank pain; most common pathogens are E. coli and Proteus.
Acute Tubular Necrosis (ATN):
- Leading cause of acute kidney injury (previously ARF), caused by ischemic or toxic agents.
- Characterized by rapid loss of kidney function, but many patients recover.

Adult Polycystic Kidney Disease:
- Autosomal dominant, leads to enlarged kidneys filled with cysts; often asymptomatic until later in life.
Childhood Polycystic Kidney Disease:
- Autosomal recessive, characterized by numerous small cortical cysts, high infant mortality.
Medullary Cystic Kidney Disease:
- Associated with chronic renal failure in children, progresses to end-stage renal disease.

Benign Nephrosclerosis:
- Linked to benign hypertension with mild functional impairment due to arterial changes.
Malignant Nephrosclerosis:
- Related to malignant hypertension; characterized by hyperplastic vessels and significant kidney ischemia.

Renal Cell Carcinoma:
- Derived from tubular epithelium; linked to smoking and high-risk factors.
- Symptoms include hematuria, abdominal mass; poor prognosis if metastatic.
Bladder Carcinoma:
- Originates from transitional epithelium, often presenting with painless hematuria.
- Prognosis varies with tumor grade and invasion depth; overall 5-year survival rate is 50%.