Difference between revisions of "Medical kidney diseases"

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Medical kidney diseases (view source)

Revision as of 18:55, 11 May 2011

37 bytes added ,  18:55, 11 May 2011
→‎Rare diseases
(+MCD)
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**Aminoglycosides,  
**Aminoglycosides,  
**Chloroquine.
**Chloroquine.
==Pyelonephritis==
===General===
*Usually diagnosed clinically: urine C&S, urine R&M, +/-CT abdomen.
===Gross===
Features:<ref name=Ref_Klatt251>{{Ref Klatt|251}}</ref>
*[[Necrosis]] of renal papillae.
===Microscopic===
Features:
*Interstitial nephritis.
==Acute tubular necrosis==
===General===
*Best diagnosed clinically (using urine R&M) - hemegranular casts are diagnostic.
*Often abbreviated ''ATN''.
===Microscopic===
Features:<ref>PS. April 2009.</ref>
*Hemegranular casts in the lumen.
*Regenerative activity (mitoses).
==Hepatorenal syndrome==
*Acute renal failure due secondary to cirrhosis or fulminant liver failure.
===Clinical===
*Urine sodium is low,<ref name=pmid1261103>{{cite journal |author=Epstein M, Oster JR, de Velasco RE |title=Hepatorenal syndrome following hemihepatectomy |journal=Clin. Nephrol. |volume=5 |issue=3 |pages=129-33 |year=1976 |month=March |pmid=1261103 |doi= |url=}}</ref> unlike in ATN (the main DDx).
===Pathophysiology===
*Renal vasoconstriction.<ref name=pmid18304678>{{cite journal |author=Angeli P, Merkel C |title=Pathogenesis and management of hepatorenal syndrome in patients with cirrhosis |journal=J. Hepatol. |volume=48 Suppl 1 |issue= |pages=S93-103 |year=2008 |pmid=18304678 |doi=10.1016/j.jhep.2008.01.010 |url=}}</ref>
===Histology===
*Normal.
===Treatment===
Medical and surgical:<ref name=pmid18417039>{{cite journal |author=Wong F |title=Hepatorenal syndrome: current management |journal=Curr Gastroenterol Rep |volume=10 |issue=1 |pages=22-9 |year=2008 |month=February |pmid=18417039 |doi= |url=}}</ref>
*Vasoconstrictors (e.g. midodrine, terlipressin (counteracts splanchnic vasodilation), norepinephrine).
*Albumin.
*TIPS (transjugular intrahepatic portosystemic shunt).
*Liver transplantation.
Note:
*I suspect a ''portal vein pump'' would work... it reduces portal pressure and would likely increase hepatic function.


==Alport disease==
==Alport disease==
Line 646: Line 602:
*Nephronophthisis.
*Nephronophthisis.
*Cystic [[renal cell carcinoma]].
*Cystic [[renal cell carcinoma]].
=Disease that does not get biopsied=
==Pyelonephritis==
===General===
*Usually diagnosed clinically: urine C&S, urine R&M, +/-CT abdomen.
===Gross===
Features:<ref name=Ref_Klatt251>{{Ref Klatt|251}}</ref>
*[[Necrosis]] of renal papillae.
===Microscopic===
Features:
*Interstitial nephritis.
==Acute tubular necrosis==
===General===
*Best diagnosed clinically (using urine R&M) - hemegranular casts are diagnostic.
*Often abbreviated ''ATN''.
===Microscopic===
Features:<ref>PS. April 2009.</ref>
*Hemegranular casts in the lumen.
*Regenerative activity (mitoses).
==Hepatorenal syndrome==
*Acute renal failure due secondary to cirrhosis or fulminant liver failure.
===Clinical===
*Urine sodium is low,<ref name=pmid1261103>{{cite journal |author=Epstein M, Oster JR, de Velasco RE |title=Hepatorenal syndrome following hemihepatectomy |journal=Clin. Nephrol. |volume=5 |issue=3 |pages=129-33 |year=1976 |month=March |pmid=1261103 |doi= |url=}}</ref> unlike in ATN (the main DDx).
===Pathophysiology===
*Renal vasoconstriction.<ref name=pmid18304678>{{cite journal |author=Angeli P, Merkel C |title=Pathogenesis and management of hepatorenal syndrome in patients with cirrhosis |journal=J. Hepatol. |volume=48 Suppl 1 |issue= |pages=S93-103 |year=2008 |pmid=18304678 |doi=10.1016/j.jhep.2008.01.010 |url=}}</ref>
===Histology===
*Normal.
===Treatment===
Medical and surgical:<ref name=pmid18417039>{{cite journal |author=Wong F |title=Hepatorenal syndrome: current management |journal=Curr Gastroenterol Rep |volume=10 |issue=1 |pages=22-9 |year=2008 |month=February |pmid=18417039 |doi= |url=}}</ref>
*Vasoconstrictors (e.g. midodrine, terlipressin (counteracts splanchnic vasodilation), norepinephrine).
*Albumin.
*TIPS (transjugular intrahepatic portosystemic shunt).
*Liver transplantation.
Note:
*I suspect a ''portal vein pump'' would work... it reduces portal pressure and would likely increase hepatic function.


=Transplant=
=Transplant=
Michael
48,466

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