Renal diseases are traditionally divided into four categories
nGlomeruli
nTubules
nInterstitium
nBlood vessels
Clinical manifestations of Renal diseases
nAcute nephritic syndrome: hematuria, mild to moderate proteinuria and hypertension.
nNephrotic syndrome: Heavy proteinuria (>3.5gm/day), hypoalbuminemia, severe edema, hyperlipidemia, and lipiduria.
nAsymptometic hematuria or proteinuria.
nAcute renal failure: recent onset of azotemia with oliguria or anuria
nChronic renal failure: prolonged uremia.
nRenal tubular defect: polyuria, nocturia, metabolic acidosis
nUrinary tract infection: bacturia, polyuria, affecting kidneys and bladder
nNephrolithisis: renal colic, hematuria.
Renal failure (Charecterized as)
nAzotemia: high BUN, high creatinine, decreased GFR
nPrerenal azotemia: hypoperfusion of the kidney in CCF, shock volume depletion,
nHemorrhage
nPostrenal azotemia: urinary out flow obstruction.
nUremia: Azotemia associated with clinical signs and symptom.
Stage of progression in renal disease
nDiminished renal reserve: 50% of GFR.
nRenal insufficiency: 20%-50% of normal GFR
nRenal failure: <20%-25% of normal GFR
nEnd stage renal disease: <5% of normal GFR
Principal systemic manifestation of chronic renal failure and uremia
nFluid and electrolytes: dehydration, edema and metabolic acidosis
nCalcium phosphate and bone: Hyperphosphatemia, hypocalcaemia, secondary hyperparathyroidism, renal osteodystrophy
nHematological: anemia, bleeding diathesis
nCardiopulmonary: Hypertension, CCF, pulmonary edema, uremia pedicarditis.
nGastrointestinal: nausea,vomiting, bleeding esophagitis gastritis, colitis
nNeuromuscular: Myopathy,peripheral neuropathy, encephalopathy.
nDermatologic: pruritis, dermatitis.
CONGENITAL ANOMALIES
nRenal agenesis: bilateral/unilateral
nHypoplasia
nEctopic Kidneys
nHorseshoe Kidney
CYSTIC DISEASES OF THE KIDNEY
nCystic renal Dysplasia
nPolycystic kidney disease: a) Autosomal dominant (adult) polycystic kidney disease. b) autosomal recessive (childhood) polycystic kidney.
nMedullary cystic disease: a) Medullary sponge kidney b) Nephronophthisis- uremic Medullary cystic disease complex
nAcquired (dialysis-associated) cystic disease
nSimple cysts
GLOMERULAR DISEASES
Primary glomerulopathies
nAcute diffuse proliferative GN
Poststeptococcal
Non-Poststeptococcal
nRapidly progressive (crescentic) GN
nMembranous glomerulopathies
nLipoid nephrosis (minimal change disease)
nFocal segmental glomeruloscerosis
nMembranoproliferative GN
nIgA nephropathy
nFocal proliferative GN
nChronic GN
Systemic Diseases
nSystemic lupus erythematosus
nDiabetes mellitus
nAmyloidosis
nGood pasture syndrome
nPolyarteritis nodosa
nWagener granulomatosis
nHenoch-schonlein purpura
nBacterial endocarditis
Hereditary Disorders
nAlport syndrome
nThin membrane disease
nFabry disease
Tumors of the kidney
nBenign : Renal papillary adenoma (3cm) Renal Fibroma or hamartoma (<1cm) Angiomyolipoma, Oncocytoma
nMalignant: Renal cell carcinoma, (hypernephroma or adenocarcinoma of the kidney)
Types: Clear cell / nonpapillary(60-80%) carcinoma, papillary carcinoma, chromophobe renal cell carcinoma.
nUrothelial carcinomas of the renal pelvis
Clinical aspect
nHematuria (90%), fever, constitutional symptom, paraneoplastic syndrome (polycythemia, hypercalcemia, hypertension, feminization or masculinization, Cushing syndrome, eosinophilia, leukaemoid reaction, Amyloidosis.
Plasma cell neoplasm:http://plasmacellneoplasm.blogspot.com/
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