Kategóriák: Minden - renal - infection - hypertension

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Chronic Renal Failure

Chronic renal failure encompasses a range of conditions leading to progressive kidney dysfunction, often culminating in end-stage renal disease. The majority of cases are attributed to hypertension and diabetes.

Chronic Renal Failure

Chronic Renal Failure

Chronic GN

<100 g kidney
Red-brown, diffusely granular surface
Symmetrically contracted

Chronic allograft nephropathy

Months or yrs after transplant
Increased BP

Analgesic abuse nephropathy

Runs a progressive course

Stop Analgesics before issues become severe
Papillary Necrosis, then TIN
Analgesic mixtures
Acetaminophen
Codeine
Caffeine
ASA
Phenacetin

ESRD

DDx

GIHAD (like jihad)

HTN, DM: >70% of cases

IN
GN

ADPKD

Most common potentially lethal single-gene disease

Course

Renal failure likely by 50s

50% by age 60

No specific RX

Rx infxn

Aspirate cysts for pain

Rx HTN

Path

2-3 Kg (HUGE)

Average: 100-150 g

Height...roughly 3 vertebral bodies

Clinical

Extrarenal

Cysts elsewhere

Intracranial Berry aneurysms

Hepatic cysts

Nephrolithiasis

Infxn

Palpable kidney

Flank, Abd pain

Hematuria

HTN b4 renal

PKD2
Chromo 4
Indolent
PKD1
Short arm, Chromo 16
85-90%
Chronic
Chronic + Obstruction = Bacterial Infection

Thyroidization

Hydronephrosis, Hydroureter

U-shaped scars

Acute
Micro

Abscess

Patchy involvement

Inflammatory cell infiltration

Gross

Enlarged

General
Factors

Calyx-tubular reflux

Vesicoureteral reflux

Paraplegia

Cystitis

Obstruction

Stones

BPH

Tumors

Spread

Bloodstream

S. Aureus

Upward

W/ or w/o Obstruction
Pelvis, Calyces, Parenchyma,
E. Coli

Hyalinization of Small Vessel Wall

Both Aff. & Eff. arterioles
DM

Pyelonephritis

Papillary necrosis

Can be seen in:

  • Diabetics
  • Acute Pyelonephritis
  • Analgesic abuse
  • Armanni-Ebstein Lesion

    Glycogen w/in epithelial cells (vacuolated)

    Glomerulus

    Exudative lesions of DM

    Lipohyalin [cap]

    Lipid

    Eosinophilic

    Diffuse > Nodular lesion

    Diffuse thickening of BM

    Kidney

    Retina

    Skeletal muscle

    Skin

    Common cause of ESRD

    Clinical Findings

    HTN

    Renal Failure

    Proteinuria

    One arteriole
    Primary HTN

    Malignant nephrosclerosis

    Onion-skin proliferation

    "Flea-bitten kidney"

    Tiny hemorrhages

    Benign nephrosclerosis