Term
| Acute Interstitial Nephritis is caused by __. It is often __ but may present with __ and occasional __ __ and __. Evaluation should include __, __, and __. |
|
Definition
- drugs
- asymptomatic
- fever
- flank/lumbar pain
- HTN
- UA
- Cr
- Biopsy |
|
|
Term
| Drugs that cause Acute Interstitial Nephritis: |
|
Definition
- Penicillin
- Sulfa drugs
- NSAIDs
- Cephalosporins |
|
|
Term
| What is a good test to distinguish b/w ATN, glomerulonephritis, and interstitial Nephritis? |
|
Definition
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Term
| UA of acute interstitial nephritis may show: |
|
Definition
- hematurian
- proteinuria
- leukocytes
- WBC casts |
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|
Term
| Acute Interstitial Nephritis causes what types of casts to show up in the urine? |
|
Definition
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Term
| Anyone with a chronic kidney disease/chronic kidney failure has __ __ __. |
|
Definition
| chronic interstitial nephritis |
|
|
Term
| Causes of chronic interstitial nephritis: |
|
Definition
- toxins
- infections
- autoimmune diseases
- HTN
- obstructive nephrophathy |
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|
Term
| Symptoms of Glomerularnephritis: |
|
Definition
- Mild edema (periorbital)
- HTN
- cola-colored urine |
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|
Term
| Causes of Glomerulonephritis: |
|
Definition
- Post-infectious (streptococall- skin or throat)
- IgA Nephropathy
- Henoch-Schonlein Purpura (HSP)
- Hemolytic Uremia Syndrome (HUS)
- Goodpasture's Syndrome
- Lupus (SLE)
- Vasculitidies: Polyarteritis nodosa, Wegener's granulomatosis
- Membranoproliferative GN
- Associated with endocarditis and visceral abscesses |
|
|
Term
| 4 common childhood causes of Glomerulonephritis: |
|
Definition
- Post-infectious (strep)
- IgA Glomerulonephropathy
- Henoch-Schonlein Purpura (HSP)
- Hemolytic Uremia Syndrome (HUS) |
|
|
Term
|
Definition
common cause of glomerulonephritis in kids
IgA deposits in the kidneys after an URI
these pts have hx of URI |
|
|
Term
| HSP is a systemic __. These patients present with __ on LE, __ __, __ problems, and a __. This is a childhood cause of __. |
|
Definition
- vasculitis
- purpura on LE
- bloody diarrhea
- joint problems
- rash
- glomerulonephritis |
|
|
Term
| Hemolytic Uremia Syndrome (HUS) occurs after __ ___, like __ or __. The toxin damages the intestinal walls as well as the kidneys resluting in ___. |
|
Definition
- bacterial gastroenteritis
- Salmonella or Shigella
- glomerulonephritis |
|
|
Term
| UA characteristics of glomerulonephritis: |
|
Definition
- hematuria
- RBC casts
- moderate proteinuria |
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|
Term
| CBC of pt with glomerulonephritis would show: |
|
Definition
- decreased RBCs
- decreased hemoglobin
- decreased hematocrit |
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|
Term
| How you monitor the progress of pt with glomerulonephritis: |
|
Definition
|
|
Term
| Eval of pt with glomerulonephritis: |
|
Definition
- UA
- IgA
- ASO titer
- ANA
- ANCA
- anti-GBM
- CBC
- Complement |
|
|
Term
| Glomerulonephritis is associated with what 2 things? |
|
Definition
- endocarditis
- visceral abscesses |
|
|
Term
| How do you treat fluid overload in pt with Glomerulonephritis? |
|
Definition
| ACE-I and diuretic, follow up in 6 months |
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|
Term
| Diff b/w Nephritis Syndrome and Nephrotic Syndrome: |
|
Definition
- Nephritic- little protein in urine
- Nephrotic- lots of protein in urine |
|
|
Term
| Nephrotic Syndrome Signs and Symptoms: |
|
Definition
GHHHHLIN
- Generalized edema
- Hyperproteinuria
- Hypoalbuminemia
- Hypercoagulability
- Hyperlipidemia
- Lipiduria
- Infections
- No HTN |
|
|
Term
| Causes of nephrotic Syndrome: |
|
Definition
- miminal change disease
- Diabetes Mellitus
- Lupus
- Membranous nephropathy: hep B, gold, pneacillamine, syphilis, carcinoma
- Focal glomeruloscerlosis: heroin, AIDS
- Amyloidosis |
|
|
Term
| With NephrOtic syndrome, there will NOT be __ in urine, this is only with Nephritic syndrome. |
|
Definition
|
|
Term
| Eval options for nephrotic syndrome: |
|
Definition
UA
24-hour urine
biopsy-rare |
|
|
Term
| Tmt for Nephrotic Syndrome: |
|
Definition
- Steroids if caused by Lupus or Minimal Change Disease
- Control pre-existing HTN
- Treat infection
- Prevention with DM: ACE-I or ARB |
|
|
Term
| MC cause of nephrotic syndrome in kids: |
|
Definition
|
|
Term
|
Definition
| These are diffuse loss of visceral epithelial cells (podocyte) foot processes.,[3] vacuolation, and growth of microvilli on the visceral epithelial cells. |
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|
Term
| Criteria for Dx of Acute Renal Failure; |
|
Definition
- Absolute increase in serum Cr of 0.3 mg/dL
- 50% increas in serum Creatinine
- Reduction in urein output (oliguria) |
|
|
Term
| Chronic kidney failure is a progressive slow irreversible decline in kidney function. What is the criteria for dx of chronic renal failure? |
|
Definition
| - GFR less than 60 ml/min/1.73m2 for 3 or more months |
|
|
Term
| Expected lab findings in Acute Renal Failure: |
|
Definition
- increased BUN
- increased Cr
- increased K+
- increased Phosphate
- Increased Magnesium
- decreased pH
- decreased bicarb (metabolic acidosis with increased anion gap) |
|
|
Term
| Expected lab findings in Acute Renal Failure: |
|
Definition
- Increased BUN, Cr, Postassium, Phosphate, Magnesium
- Decreased pH, Bicarbonate
- Metabolic acidosis witn increased anion gap |
|
|
Term
| Lab findings expected with pre-renal failure: |
|
Definition
- labs for acute renal failure +
- BUN:Cr ratio > 20:1
- High urine osmolality (>500mOsm/kg)
- Low FENa (<1%) |
|
|
Term
| Tmt for pre-renal failure: |
|
Definition
- treat cause
- IV fluids
- antibiotics
- blood transfusion
- treat heart failure/valvular disease |
|
|
Term
| What causes Granular Casts? |
|
Definition
| Acute Tubular Necrosis- Intrinsic acute renal failure |
|
|
Term
| causes of Acute Tubular Necrosis Intrinsic Acute Renal Failure: |
|
Definition
- Ischemic Hypotension
- Nephrotoxic: aminoglycosides, iodinated contrast, hemoglobin, myoglobin |
|
|
Term
| Locations of Intrinsic Acute Renal Failure: |
|
Definition
- Tubules
- Vasculature
- Glomerulus
- Interstitium |
|
|
Term
| Causes of Vasculature Intrinsic Acute Renal Failure: |
|
Definition
- vasculitis
- malignant HTN |
|
|
Term
| causes of glomerular associated intrinsic acute renal failure: |
|
Definition
| glomerulonephritis...causes? |
|
|
Term
| causes of interstitium associated instrinsic acute renal failure |
|
Definition
| Interstitial nephritis...causes? |
|
|
Term
| Lab findings of Intrinsic Renal Failure: |
|
Definition
- labs associated with acute renal failure plus
- BUN:Cr of 10-15:1
- Granular/renal epithelial casts
- Low urine osmolality (< 350 mOsm/kg)
- High FENa (>2%) |
|
|
Term
|
Definition
- remove offending agent
- supportive care
- dialysis |
|
|
Term
| Postrenal Acute Renal Failure Labs: |
|
Definition
- labs expected with acute renal failure plus
- BUN:Cr and urine osmolality will vary based on extent of obstruction |
|
|
Term
| causes of Chronic Renal Failure: |
|
Definition
- DM (most common cause)
- HTN
- Lupus
- Chronic glomerulonephritis
- Polycystic kidney disease |
|
|
Term
| Signs and Symptoms of Chronic Renal Failure: |
|
Definition
- Fatigue
- Dry skin
- Pruritis
- Anorexia
- Nausea
- GI bleeding
- Neuropahty
- Pericarditis
- Arrhythmia
- Osteodystrophy (secondary hyperparathyroidism)
- Platelet dysfunction |
|
|
Term
| Lab differences b/w acute and chronic renal failure: |
|
Definition
| - with chronic renal failure you would see decreased calcium and hematocrit (would not see this with acute) |
|
|
Term
| Eval of chronic renal failure: |
|
Definition
- UA
- microalbumin
- 24 hour urine for protein
- CMP for GFR
- renal biopsy |
|
|
Term
| Chronic renal failure lab findings: |
|
Definition
- increased BUN, Cr, K+, phosphate, and magnesium
- decreased pH, bicarbonate, calcium, and hematocrit (metabolic acidosis with increased anion gap) |
|
|
Term
| Summary of stages of renal failure: |
|
Definition
Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2)
Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2)
Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m2)
Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2)
Stage 5: Kidney failure (GFR <15 mL/min/1.73 m2 or dialysis) |
|
|
Term
|
Definition
| - kidney damage with normal or increased GFR (>90mL/min) |
|
|
Term
|
Definition
| Mild reduction in GFR (60-89 mL/min) |
|
|
Term
|
Definition
| moderate reduction in GFR (30-59 ml/min) |
|
|
Term
|
Definition
| Sever reduction in GFR (15-29 ml/min) |
|
|
Term
|
Definition
| Kidney failure GFR < 15 or dialysis |
|
|
Term
| Chronic Renal Failure tmt: |
|
Definition
- low protein diet
- control HTN
- tight glycemic control
- erythropoietin, calcium, and vitamin D supplements
- monitor meds
- dialysis
- transplant |
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