Medical ultrasound

ultrasoundultrasonographymedical ultrasonography
In nephrology, ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. US is an accessible, versatile, inexpensive, and fast aid for decision-making in patients with renal symptoms and for guidance in renal intervention. Renal ultrasound (US) is a common examination, which has been performed for decades. Using B-mode imaging, assessment of renal anatomy is easily performed, and US is often used as image guidance for renal interventions.

Autoimmune disease

autoimmune diseasesautoimmune disorderautoimmune
Goodpasture's disease which may affect the basement membrane in both the lung and the kidney). There are many theories as to how an autoimmune disease state arises. Some common ones are listed below. Although it is possible for a potential autoantigen to be spatially sequestered in an immune privileged site within the body (e.g. the eye), mechanisms exist to express even these antigens in a tolerogenic fashion to the immune system. However, it is impossible to induce tolerance (immune unresponsiveness) to all aspects of an autoantigen. This is because under normal physiologic conditions some regions of a self-antigen are not expressed at a sufficient level to induce tolerance.

Diabetes

diabetes mellitusdiabeticdiabetics
The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves. Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness. Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that people with diabetes visit an eye doctor once a year. Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation.

Anatomical pathology

pathological anatomyanatomic pathologypathologist
Its use has been largely supplanted by immunohistochemistry, but it is still in common use for certain tasks, including the diagnosis of kidney disease and the identification of immotile cilia syndrome. Tissue cytogenetics – the visualization of chromosomes to identify genetic defects such as chromosomal translocation. Flow immunophenotyping – the determination of the immunophenotype of cells using flow cytometry techniques. It is very useful to diagnose the different types of leukemia and lymphoma. Academic anatomical pathology is practiced at university medical centers by pathologists who are also university faculty.

Diuretic

diureticsdiuretic medicationsdiuretic use
This is large in comparison to normal renal sodium reabsorption which leaves only about 0.4% of filtered sodium in the urine. Loop diuretics have this ability, and are therefore often synonymous with high ceiling diuretics. Loop diuretics, such as furosemide, inhibit the body's ability to reabsorb sodium at the ascending loop in the nephron, which leads to an excretion of water in the urine, whereas water normally follows sodium back into the extracellular fluid. Other examples of high ceiling loop diuretics include ethacrynic acid and torasemide.

Cholesterol

total cholesteroldietary cholesterolserum cholesterol
Major dietary sources of cholesterol include red meat, egg yolks and whole eggs, liver, kidney, giblets, fish oil, and butter. Human breast milk also contains significant quantities of cholesterol. Plant cells synthesize cholesterol as a precursor for other compounds, such as phytosterols and steroidal glycoalkaloids, with cholesterol remaining in plant foods only in minor amounts or absent. Some plant foods, such as avocado, flax seeds and peanuts, contain phytosterols, which compete with cholesterol for absorption in the intestines, reduce the absorption of both dietary and bile cholesterol.

ACE inhibitor

ACE inhibitorsangiotensin converting enzyme inhibitorangiotensin-converting enzyme inhibitor
However, the decrease may be significant in conditions of decreased renal perfusion, such as renal artery stenosis, heart failure, polycystic kidney disease, or volume depletion. In these patients, maintenance of GFR depends on angiotensin-II-dependent efferent vasomotor tone. Therefore, renal function should be closely monitored over the first few days after initiation of treatment with ACE inhibitor in patients with decreased renal perfusion. A moderate reduction in renal function, no greater than 30% rise in serum creatinine, that is stabilized after a week of treatment is deemed acceptable as part of the therapeutic effect, providing the residual renal function is sufficient.

Vasculitis

vasculitidesvasculiticvasculitis, central nervous system
Kidneys: Glomerulonephritis. Underlying cause. For example, the cause of syphilitic aortitis is infectious (aortitis simply refers to inflammation of the aorta, which is an artery.) However, the causes of many forms of vasculitis are poorly understood. There is usually an immune component, but the trigger is often not identified. In these cases, the antibody found is sometimes used in classification, as in ANCA-associated vasculitides. Location of the affected vessels.

Congenital nephrotic syndrome

congenitalcongenital nephrosiscongenital nephrotic syndrome.
While infants with infectious causes of congenital nephrotic syndrome may improve with antibiotics or antiviral medications, those with genetic causes progress to end-stage renal disease and require dialysis, and ultimately a kidney transplant. Congenital nephrotic syndrome can be successfully controlled with early diagnosis and aggressive treatment including albumin infusions, nephrectomy, and medications. Affected children have rapid decline in kidney function resulting in end-stage renal disease within the first years of life, and require treatment with dialysis and kidney transplantation.

Metastasis

metastaticmetastasesmetastasized
This is typical route of metastasis for sarcomas, but it is also the favored route for certain types of carcinoma, such as renal cell carcinoma originating in the kidney. Because of their thinner walls, veins are more frequently invaded than are arteries, and metastasis tends to follow the pattern of venous flow. That is, hematogenous spread often follows distinct patterns depending on the location of the primary tumor. For example, colorectal cancer spreads primarily through the portal vein to the liver. Some tumors, especially carcinomas may metastasize along anatomical canalicular spaces.

Steroid

steroidssteroidogenesisbiosynthesis of steroids
Corticosteroids, including most synthetic steroid drugs, with natural product classes the glucocorticoids (which regulate many aspects of metabolism and immune function) and the mineralocorticoids (which help maintain blood volume and control renal excretion of electrolytes). Anabolic steroids, natural and synthetic, which interact with androgen receptors to increase muscle and bone synthesis. In popular use, the term "steroids" often refers to anabolic steroids. Corticosteroids:. Glucocorticoids:. Cortisol, a glucocorticoid whose functions include immunosuppression. Mineralocorticoids:.

Fluid balance

diuresiseuvolemicfluid
Thus, there will be an increase in the secretion of antidiuretic hormone, causing fluid to be retained by the kidneys and urine output to be reduced. A fluid-insufficiency causes a decreased perfusion of the juxtaglomerular apparatus in the kidneys. This activates the renin–angiotensin system. Among other actions, it causes renal tubules (i.e. the distal convoluted tubules and the cortical collecting ducts) to reabsorb more sodium and water from the urine. Potassium is secreted into the tubule in exchange for the sodium, which is reabsorbed. The activated renin–angiotensin system stimulates the zona glomerulosa of the adrenal cortex which in turn secretes the hormone aldosterone.

Hemoglobin

haemoglobinoxyhemoglobindeoxyhemoglobin
Improperly degraded hemoglobin protein or hemoglobin that has been released from the blood cells too rapidly can clog small blood vessels, especially the delicate blood filtering vessels of the kidneys, causing kidney damage. Iron is removed from heme and salvaged for later use, it is stored as hemosiderin or ferritin in tissues and transported in plasma by beta globulins as transferrins. When the porphyrin ring is broken up, the fragments are normally secreted as a yellow pigment called bilirubin, which is secreted into the intestines as bile. Intestines metabolise bilirubin into urobilinogen. Urobilinogen leaves the body in faeces, in a pigment called stercobilin.

Jaundice

Obstructive jaundiceicteruscholestatic jaundice
It can either be further converted into stercobilinogen, which is then oxidized to stercobilin and passed out in the feces, or it can be reabsorbed by the intestinal cells, transported in the blood to the kidneys, and passed out in the urine as the oxidised product urobilin. Stercobilin and urobilin are the products responsible for the coloration of feces and urine, respectively. It is unclear how common jaundice is among adults. Most people presenting with jaundice will have various predictable patterns of liver panel abnormalities, though significant variation does exist.

Antihypertensive drug

antihypertensiveantihypertensivesantihypertensive agent
Chronic kidney disease. ACE inhibitors or ARBs should be included in the treatment plan to improve kidney outcomes regardless of race or diabetic status. Late-stage Dementia should consider Deprescribing antihypertensives, according to the [[Medication appropriateness tool for co‐morbid health conditions in dementia (MATCH-D) criteria|Medication Appropriateness Tool for Comorbid Health Conditions in Dementia (MATCH-D)]]. Diabetes mellitus. The ACE inhibitors and angiotensin receptor blockers have been shown to prevent the kidney and retinal complications of diabetes mellitus. Gout may be worsened by thiazide diuretics, while losartan reduces serum urate.

Immunosuppressive drug

immunosuppressantcalcineurin inhibitorimmunosuppressive drugs
National Kidney Foundation: A to Z Health Guide, answers to some frequently asked questions about immunosuppression in renal transplantation for a layman. Accessed on 21 August 2005. Immunosuppressants, Pharmacologic profile. Drugguide.com. Accessed on 15 March 2016. Immunosuppressants, a collection of links at About.com. Accessed ob 21 August 2005.

List of ICD-9 codes 580–629: diseases of the genitourinary system

Nephrotic syndrome. Nephrotic syndrome, unspec. Chronic glomerulonephritis. Glomerulonephritis, chronic, unspec. Nephritis and nephropathy, not specified as acute or chronic. Acute renal failure. Renal failure, acute w/ tubular necrosis. Renal failure, acute, unspec. Chronic renal failure. Renal failure, unspecified. Renal sclerosis, unspecified. Disorders resulting from impaired renal function. Other specified disorders resulting from impaired renal function. Hyperparathyroidism, secondary, renal. Renal tubular acidosis. Small kidney of unknown cause. Infections of kidney. Chronic pyelonephritis w/o lesion of renal medullary necrosis. Pyelonephritis, acute, w/o necrosis. Hydronephrosis.

ICD-10 Chapter XIV: Diseases of the genitourinary system

Genito-urinary diseaseurinary tract diseases
Renal osteodystrophy. Azotaemic osteodystrophy. Phosphate-losing tubular disorders. Nephrogenic diabetes insipidus. Other disorders resulting from impaired renal tubular function. Lightwood-Albright syndrome. Renal tubular acidosis NOS. Secondary hyperparathyroidism of renal origin. Disorder resulting from impaired renal tubular function, unspecified. Unspecified contracted kidney. Small kidney of unknown cause. Other disorders of kidney and ureter, not elsewhere classified. Ischaemia and infarction of kidney. Cyst of kidney, acquired. Other specified disorders of kidney and ureter. Hypertrophy of kidney. Megaloureter. Nephroptosis. Pyelitis. Pyeloureteritis. Ureteritis. Ureterocele.

Metolazone

ZaroxolynDiulometalozone
Although most thiazide diuretics lose their effectiveness in renal failure, metolazone remains active even when the glomerular filtration rate (GFR) is below 30–40 mL/min (moderate renal failure). This gives it a considerable advantage over other thiazide diuretics, since renal and heart failure often coexist and contribute to fluid retention. Metolazone may also be used in kidney disease, such as chronic kidney disease or the nephrotic syndrome. Chronic kidney disease causes excess fluid retention that is often treated with diet adjustments and diuretics.

Urologic disease

uropathyuropathogenicurologic
Kidney disease, or renal disease, also known as nephropathy, is damage to or disease of a kidney. Nephritis is an inflammatory kidney disease and has several types according to the location of the inflammation. Inflammation can be diagnosed by blood tests. Nephrosis is non-inflammatory kidney disease. Nephritis and nephrosis can give rise to nephritic syndrome and nephrotic syndrome respectively. Kidney disease usually causes a loss of kidney function to some degree and can result in kidney failure, the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney transplant is the only treatment option.

Jonah Lomu

Jonah Tali LomuLomu
At the end of 1995, Lomu was diagnosed with nephrotic syndrome, a serious kidney disorder. His rugby union career went on hold whilst the disorder was treated. In May 2003, the NZRFU announced that Lomu had been put on dialysis three times a week due to deterioration in his kidney function. Side effects of Lomu's dialysis treatment led to severe nerve damage in his feet and legs; his doctors warned him that he faced life in a wheelchair if a kidney transplant was not performed soon. At the end of July 2004 it was reported that Lomu had indeed undergone a kidney transplant on Tuesday, 28 July, in Auckland, New Zealand. The kidney was donated by Wellington radio presenter Grant Kereama.

Henoch–Schönlein purpura

Henoch-Schonlein purpuraIgA vasculitispurpura, schoenlein-henoch
Forty percent have evidence of kidney involvement, mainly in the form of hematuria (blood in the urine), but only a quarter will have this in sufficient quantities to be noticeable without laboratory tests. Problems in other organs, such as the central nervous system (brain and spinal cord) and lungs may occur, but is much less common than in the skin, bowel and kidneys. Of the 40% of patients who develop kidney involvement, almost all have evidence (visible or on urinalysis) of blood in the urine. More than half also have proteinuria (protein in the urine), which in one eighth is severe enough to cause nephrotic syndrome (generalised swelling due to low protein content of the blood).

IgA nephropathy

Berger's diseaseBerger diseaseglomerulonephritis, iga
. * IGA Nephropathy on National Institute of Diabetes and Digestive and Kidney Diseases Severe flank/abdominal pain. High blood pressure. Hematuria (gross, frank, microscopic). Compromised immune system. Edema in hands and feet. Cola- or tea-colored urine. Nephrotic syndrome (3-3.5 grams of protein loss in the urine, associated with a poorer prognosis). Acute kidney failure (either as a complication of the frank hematuria, when it usually recovers, or due to rapidly progressive glomerulonephritis which often leads to chronic kidney failure).

Sickle cell nephropathy

sickle-cell nephropathy
Many of these individuals eventually develop a glomerulopathy leading to glomerular proteinuria (present in as many as 30%) and, in some, the nephrotic syndrome. Co-inheritance of microdeletions in the -globin gene (thalassemia) appear to protect against the development of nephropathy and are associated with lower mean arterial pressure and less protein in the urine. Mild increases in the blood levels of nitrogen and uric acid can also develop. Advanced kidney failure and high blood urea levels occur in 10% of cases. Pathologic examination reveals the typical lesion of "hyperfiltration nephropathy" namely, focal segmental glomerular sclerosis.

Cholesterol embolism

cholesterol embolicholesterolCholesterol embolus
Increased amounts of protein in the urine may cause edema (swelling) of the skin (a combination of symptoms known as nephrotic syndrome). If emboli have spread to the digestive tract, reduced appetite, nausea and vomiting may occur, as well as nonspecific abdominal pain, gastrointestinal hemorrhage (vomiting blood, or admixture of blood in the stool), and occasionally acute pancreatitis (inflammation of the pancreas). Both the central nervous system (brain and spinal cord) and the peripheral nervous system may be involved. Emboli to the brain may cause stroke-like episodes, headache and episodes of loss of vision in one eye (known as amaurosis fugax).