radiolucent kidney stoneradiolUcent(放射線透過性)
→Uric acid (5% of kidney stones)
(however, can be seen on noncontrast CT) urologyrenal May 31, 2019, 4:25 AM HirotoShishido
how ACE inhibitor and Ca inhibitor affect GFRACE inhibitor→dilate efferent arteriole→↓Pgc(glomerular capillary pressure)→↓GFR(↑RPF)
Ca inhibitor→dilate afferent arteriole→↑Pgc→↑GFR(↑RPF) renal May 28, 2019, 8:40 PM HirotoShishido
hepatorenal syndrome
pathogenesis,diagnosis,treatment,prognosis(肝腎症候群)
progressive functional renal failure caused by reduction in the GFR due to declining hepatic function
kidney anatomy is completely unaffected(normal size and shape)
confirmed characteristic of postrenal failureurine osmolality<350 mOsm/kg
kidneys are unable to effectively concentrate the urine renal Jun 2, 2019, 12:23 AM HirotoShishido
GFR=?? clearanceinulin
creatinin clearance is an approximate measure of GFR(slightly overestimate GFR cos creatinin is moderately secreted by renal tubules) renal Jun 2, 2019, 12:53 AM HirotoShishido
thyazide like diuretics
(metalic laser gun→)metolazone
(Indian→)indapamide
(colorful salad→)chlorthalidone
(water baloon→)hypertension&edematous states
(sippy cup→)nephrogenic diabetes insipidus
(milk bottle→)kidney stone
(bone→)osteoporosis
(candy bar→)hyperglycemia
(butter→)hyperlipidemia
(red rash→)sulfa allergy
hyperuricemia,hypercalcemia,hypokalemic metabolic alkalosis pharmacologyrenal May 31, 2019, 2:01 AM HirotoShishido
indications for acute dialysis in DICAIUEO
Acidosis refractory to bicarbonate
Intoxcation with some drugs
Uremic symptoms(eg. cardiac friction rub,altered mental status)
Electrolyte abnormality(especially potassium)
volume Overload refractory to diuretics renal May 31, 2019, 4:12 AM HirotoShishido
nephrotic syndrome+thrombmembolic eventsdue to renal losses of antithrombin Ⅲ,protein C,protein S renal May 28, 2019, 7:44 PM HirotoShishido
pathogenesis of Goodpasture synd
+risk factorstype Ⅱ hypersensitivity reaction targetting α3chain in collagenⅣ forming glomerular and alveolar basement membrane
genetic:HLA-DR15
environmental:infection,smoking,oxidative stress,hydrocarbon-based solvents(as in dry cleaning industry)→damage α4,α5 chains in collagen Ⅳ and expose α3 renal May 25, 2019, 3:46 AM HirotoShishido
HIV infection, heroin abuse,sickle cell disease renal May 27, 2019, 4:28 AM HirotoShishido
angiotensin Ⅱ and prostagrandins effects to renal arteriolesPDA and ACE
Prostagrandins Dilate Afferent arteriole
Angiotensin Ⅱ Constricts Efferent arteriole renal May 27, 2019, 4:02 AM HirotoShishido
the most common cause of nephrotic synd in children
cause, diagnosisminimal change disease
often 1° (idiopathic)
2° to lymphoma(cytokine mediated damage)
LM→normal glomeruli
IF→−
EM→effacement of podocyte foot process renal May 25, 2019, 10:37 PM HirotoShishido
the cause of diabetic glomerulo-nephropathy
diagnosishyperglycemia→nonenzymatic glycation of tissue proteins→hyaline arteriosclerosis→obstruction of blood flow(in efferent arteriole)→arteriole dialation(afferent arteriole)→hyperfiltration→albumiuria→decreased filtration→renal failure
