Urinary

• Chronic Kidney Disease

  Glomerular loss and disease secondary to diabetes
• Diabetic Nephropathy

  Nephron damage, often autoimmune origin, many different types of lesions
• Glomerulonephritis


  Inflammation of the glomeruli and renal dysfunction
• Nephrotic Syndrome


  Presence of heavy proteinuria, hypoalbuminemia, and peripheral edema
• Nephritic Syndrome

  Most common cause is immunological (IgA nephropathy), post-infections, lupus nephritis
• Hypertensive Nephropathy


  Progressive kidney damage, long-standing, poorly controlled high blood pressure, lesion = Arteriolar nephrosclerosis
• Uremia is characterized by long standing, progressive nature, systemic effects, treatable but irreversible
• Causes of chronic kidney disease

  Diabetes

  Hypertension

  Glomerulonephritis

  Polycystic kidney disease
• Common Symptoms of chronic kidney disease

  Fatigue

  Ammonia-smelling breath

  Loss of appetite

  Foamy urine

  Difficulty urinating or frequent urination

  Kidney pain
• Complications of chronic Kidney disease

  Uremic syndrome

  Atherosclerotic disease

  Dyslipediemia

  Hypertension and pitting oedema

  secondary hyperparathyroidism
• Symptoms of diabetic nephropathy

  Swollen ankles, feet and hands

  Nausea and loss of appetite

  Fatigue and insomnia

  Dry, itchy skin

  Difficulty in concentrating
• Secondary causes of nephrotic syndrome

  Metabolic - diabetes mellitus

  Immunologic

  Neoplastic - carcinoma

  Medication/drugs - heroin

  Infection - syphilis, herpes zoster, hepatitis B/C

  Allergic

  Genetic syndromes
• Nephrotic syndrome Pathophysiology

  Injury to podocytes

  Podocyte foot process effacement & detachment

  Protein leaks into urine
• Symptoms of nephrotic syndrome

  Oedema

  Pale skin, fissure

  Hyperlipidemia

  Protein in urine - looks foamy

  Vomitting

  Tachycardia
• Nephrotic Syndrome

  Inflammation of the glomeruli and renal dysfunction
• Nephritic Syndrome Pathophysiology

  Deposition of immune complexes of antibodies triggers inflammation

  Imflammation injures cells and degrades the glomerular basement membrane

  RBC leak into urine and some protein in urine
• Symptoms of nephritic syndrome

  Blood in the urine

  Blurred vision

  Hypertension

  Low output of urine

  Abnormally high levels of nitrogen-containing substance

  Protein in urine