Renal Diseases II
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Questions and Answers

What characterizes acute renal failure compared to chronic renal failure?

  • It occurs gradually over months.
  • It is always irreversible.
  • It has no initial symptoms.
  • It is a sudden, sharp decline in renal function. (correct)

    • Which of the following is a cause of pre-renal failure?

  • Dehydration. (correct)
  • Acute tubular necrosis.
  • Prostatic enlargement.
  • Heavy metal poisoning.

    • What is the primary distinction between intra-renal and pre-renal failure?

  • Intra-renal failure has a higher urinary sodium concentration than pre-renal failure. (correct)
  • Pre-renal failure shows elevated serum creatinine while intra-renal does not.
  • Intra-renal failure occurs due to systemic causes.
  • Pre-renal failure is always reversible.

    • Which of the following symptoms is most associated with acute renal failure?

    <p>Oliguria and anuria.</p> Signup and view all the answers

    What condition represents a defect occurring after the kidney in the urinary tract?

    <p>Calculi.</p> Signup and view all the answers

    Which of the following is NOT a feature of chronic renal failure?

    <p>Rapidly reversible kidney damage.</p> Signup and view all the answers

    What is a characteristic feature of Distal Renal Tubular Acidosis (type I)?

    <p>Impaired hydrogen ion excretion</p> Signup and view all the answers

    What would a urine/plasma urea ratio greater than 14 indicate?

    <p>Pre-renal failure.</p> Signup and view all the answers

    What condition results from the insensitivity of kidney tubules to Antidiuretic hormone (ADH)?

    <p>Nephrogenic Diabetes Insipidus</p> Signup and view all the answers

    Which of the following is NOT a feature of Fanconi's Syndrome?

    <p>Impaired hydrogen ion secretion</p> Signup and view all the answers

    What lab finding is commonly elevated in renal failure?

    <p>Elevated serum creatinine.</p> Signup and view all the answers

    Which type of renal calculi is associated with hyperparathyroidism?

    <p>Calcium Oxalate stones</p> Signup and view all the answers

    Which of the following conditions does NOT typically lead to pre-renal failure?

    <p>Analgesic toxicity.</p> Signup and view all the answers

    Which form of renal failure is defined as having defects within the kidney itself?

    <p>Intra-renal failure.</p> Signup and view all the answers

    What is a common cause of urinary tract infections related to renal calculi?

    <p>Dehydration</p> Signup and view all the answers

    Which type of Renal Tubular Acidosis is associated with decreased bicarbonate reabsorption?

    <p>Proximal RTA (Type II)</p> Signup and view all the answers

    Which of the following best describes the renal condition characterized by acidosis and excessive amino acids in urine?

    <p>Fanconi's Syndrome</p> Signup and view all the answers

    What is a potential complication of renal calculi?

    <p>Obstruction and hematuria</p> Signup and view all the answers

    What results from aldosterone resistance or deficiency in renal tubular function?

    <p>Type IV (Hyperkalaemic) RTA</p> Signup and view all the answers

    What is an incorrect notion about nephrogenic diabetes insipidus?

    <p>It results in concentrated urine.</p> Signup and view all the answers

    Signup and view all the answers

    Study Notes

    Renal Diseases II

    • This presentation covers various kidney diseases, their causes, clinical features, and lab results
    • It includes Renal Tubular Acidosis, Nephrogenic Diabetes Insipidus, Fanconi's Syndrome, Renal Calculi, Acute Renal Failure, and Chronic Renal Failure
    • The presentation divides the kidney diseases into different categories for easier understanding.

    Tubular Diseases

    • Tubular defects cause decreased excretion/reabsorption of substances in urine.
    • This can result in reduced concentrating capability of the kidneys
    • Includes Renal Tubular Acidosis (RTA), Nephrogenic Diabetes Insipidus (NDI), and Fanconi's Syndrome.

    Renal Tubular Acidosis (RTA)

    • Clinically, RTA is the most significant type of tubule diseases.
    • It's caused by inherited or acquired disorders.
    • These disorders affect either the proximal or distal convoluted tubules.
    • Failure to retain bicarbonate, or inability of tubules to secrete hydrogen ions results in RTA.
    • RTA subtypes are classified based on the type of tubular defect.
    • Distal RTA (type 1) has impaired hydrogen ion excretion resulting in inability to acidify urine.
    • Proximal RTA (type II) has decreased bicarbonate reabsorption causing acidosis.
    • Type IV RTA is hyperkalemic and secondary to aldosterone resistance or deficiency.

    Nephrogenic Diabetes Insipidus (NDI)

    • NDI is a disorder with excessive thirst and excretion of large volumes of severely diluted urine.
    • The kidneys' tubules are not responsive to Antidiuretic hormone (ADH).

    Fanconi's Syndrome

    • Fanconi's syndrome involves inherited or acquired disorders of kidney's tubule function.
    • The main symptoms include generalized aminoaciduria, glycosuria, phosphaturia, and acidosis.

    Renal Calculi (Kidney Stones)

    • Kidney stones are formed from various crystallized substances.
    • They are caused by decreased fluid intake, dehydration, and urine saturation with insoluble substances.
    • Kidney stones can lead to obstruction, hematuria (blood in urine), urinary tract infections (UTIs), and abdominal pain.

    Types of Renal Calculi

    • Calcium oxalate stones are associated with hyperparathyroidism, calciuria, vitamin D toxicity, and osteoporosis.
    • Calcium phosphate stones form due to excessive alkali consumption, and infections like urease-producing organisms.
    • Uric acid stones are associated with gout and hyperuricemia.
    • Magnesium ammonium phosphate stones form due to infectious processes.
    • Cystine stones result from inherited cystinuria.

    Renal Failure

    • Renal failure is categorized based on the rate of kidney damage.
    • It includes Acute Renal Failure and Chronic Renal Failure.

    Acute Renal Failure

    • Acute Renal Failure (ARF) is a sudden decline in renal function due to acute toxic or hypoxic damage to the kidneys.
    • Diagnosis is made when excretory kidney function falls in hours to days.
    • ARF can be reversible (recovery) or progress to chronic renal failure.
    • ARF can be divided into three types: pre-renal, primary/intra-renal, and post-renal.

    Pre-renal Failure

    • Pre-renal failure results from reduced blood flow to the kidneys due to hypovolemia (e.g., haemorrhage, dehydration, shock), or decreased cardiac output (e.g., congestive cardiac failure).

    Primary (Intra) Renal Failure

    • Intra-renal failure's cause is damage within the kidneys themselves.
    • Causes include acute glomerulonephritis, acute tubular necrosis, heavy metal/solvent poisoning, and analgesic/aminoglycoside toxicities.

    Post-Renal Failure

    • Post-renal failure is caused by blockages in the urinary tract after the kidney, like calculi (kidney stones), prostatic enlargement, or bladder/prostate tumors.

    Chronic Renal Failure (CKD)

    • Chronic Renal Failure, or Chronic Kidney Disease (CKD), involves a gradual decline in renal function over time.
    • CKD is irreversible.
    • Common causes include uncontrolled diabetes mellitus, hypertension, chronic glomerulonephritis, inflammatory diseases like pyelonephritis, radiation nephritis, renal obstruction, and polycystic kidney disease.

    Clinical Features of Kidney Failure (general)

    • Symptoms such as oliguria (low urine output) and anuria (no urine output).
    • Decreased ability to excrete electrolytes and water leads to fluid buildup and edema.
    • Hypertension and congestive heart failure can develop.
    • Elevated BUN (blood urea nitrogen) and serum creatinine levels are often observed.

    Clinical Features of CKD

    • Polyuria (high urine output), hypertension, nausea, vomiting, muscle and bone weakness.
    • Abnormal levels of Na, K, Ca, and PO4 are common findings.
    • Anemia is also a common result.
    • Metabolic acidosis is a clinical feature in advanced CKD.

    Stages of Chronic Kidney Disease

    • Kidney function is assessed using GFR (glomerular filtration rate).
    • GFRs are used to determine the stage of kidney disease, from risk factors to complete failure.

    Risk Factors for Kidney Disease

    • Significant risk factors for kidney disease include high blood pressure, diabetes, heart disease, smoking, obesity, and a family history of kidney disease.

    Best Foods for Healthy Kidneys

    • The presentation suggests fish, bran bread, apple, watermelon, pumpkin, and herbs as beneficial for kidney health.

    Renal Replacement Therapy

    • Renal replacement therapy is a treatment option for kidney disease.

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    Renal Diseases II PDF

    Description

    This quiz focuses on various kidney diseases, their causes, clinical features, and lab results. Key topics include Renal Tubular Acidosis, Nephrogenic Diabetes Insipidus, and Fanconi's Syndrome. The information is categorized for easier understanding of these conditions.

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