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**Aminoglycosides, | **Aminoglycosides, | ||
**Chloroquine. | **Chloroquine. | ||
==Alport disease== | ==Alport disease== | ||
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*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= |
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