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 HirotoShishido
GFR=?? clearanceinulin
creatinin clearance is an approximate measure of GFR(slightly overestimate GFR cos creatinin is moderately secreted by renal tubules) renal HirotoShishido
angiotensin Ⅱ and prostagrandins effects to renal arteriolesPDA and ACE
Prostagrandins Dilate Afferent arteriole
Angiotensin Ⅱ Constricts Efferent arteriole renal 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 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
