Part Two Etiology Pathophysiology of Chronic Kidney Disease

Part Two: Etiology & Pathophysiology of Chronic Kidney Disease By T. Parent Nurse Educator, PHC Community Hemodialysis Units 2015

Glomerular disorders Glomeruloscle rosis Focal segmental glomerulosclerosis (FSGS) Ig. A Nephropathy

Nephrotic & Nephritic syndromes Non specific kidney disorders a rea i m e t o Pr u ein n mi u alb o yp H a a m de E d e p Hy i rlip i m e Nephrotic syndrome the loss of a lot of protein ria tu a em H li O ia r gu em t o z A n ia o si n e t r e p y H Nephritic syndrome the loss of a lot of blood

Associated Diseases Minimal change glomerulonep hritis Nephrotic Focal Segmental glomeruloscl erosis Membranoprolif erative Glomerulonephri tis Membranous Glomerulonep hritis Post streptococcal glomerulonep hritis Diabetic Nephropathy Goodpast ures Nephritic Rapidly progressive glomerulone phritis Vasculitis disorder Wegners granulomat osis Ig. A Nephropath y Microscop ic polyangiti s Churg Strauss disease Henoch. Schonlein purpura

Vascular Diseases Microscopic Polyangiitis Wegener’s BLOOD VESSEL SIZE Small to Medium BLOOD VESSEL TYPE Arterioles to venules, And sometimes Arteries and veins GRANULOMATOUS INFLAMMATION NO YES LUNG SYMPTOMS YES 1 GLOMERULONEPHRITIS YES RENAL HYPERTENSION NO NO MONONEURITIS MULTIPLEX COMMON OCCASIONAL SKIN LESIONS YES 2 GI SYMPTOMS NO NO EYE SYMPTOMS YES 4 ANCA-POSITIVITY 75% 65 -90% CONSTITUTIONALSYMPT OMS YES 5 NECROTIZING TISSUE YES MICROANEURYSMS RARELY

Medullary sponge kidney

Neoplasms Fibromuscular dysplasia (FMD) Wilms’ tumor Transitional cell cancer Renal Cell cancer

Interstitial diseases allergic drug reactions infections Acute interstitial nephritis (AIN) immunologically mediated disorders infections Chronic tubulointerstitial nephritis (CTIN reflux or obstructive nephropath drugs