Glomerulonephritis
What is glomerunephritis?
Inflammation of the glomeruli
What is nephrotic syndrome?
Glomerulus permeable to plasma protein causing proteinuria leading to low albumin and edema
What are renal calculi?
This are also known as kidney stones.
What is diagnostics for renal calculi?
Noncontrast helical (spiral) CT scan
Ultrasound
Urinalysis
24-hour urine
Retrieval and analysis of stones—important to determine problem contributing to stone formation
Describe renal artery stenosis
Partial occlusion of one or both renal arteries and major branches
Causes: atherosclerosis
Manifestations: sudden HTN
• Ages less than 30 and more than 50 years
Diagnostic studies: renal duplex Doppler ultrasound, CT or MRI angiography, and renal arteriogram
Treatment goals:
Control BP and restore renal perfusion
Treatments: Percutaneous transluminal renal angioplasty, Surgical revascularization, Nephrectomy (if one kidney involved
What is the manifestations of glomerulonephritis?
Generalized edema, hypertension, oliguria, hematuria, varying degrees of proteinuria, fluid retention
Periorbital edema first then progresses to total body including ascites and peripheral edema
Smoky urine—bleeding in upper urinary tract
Proteinuria—varies with glomerulonephropathy
HTN—increased ECF volume
Abdominal or flank pain
May be asymptomatic; found on routine urinalysis
What are the manifestations of nephrotic syndrome?
Peripheral edema, massive proteinuria, HTN, hyperlipidemia, hypoalbuminemia, foamy urine
• Decreased albumin; ascites and anasarca when severe hypoalbuminemia is present
• Immune response altered results in infection
• Hypocalcemia and skeletal abnormalities
• Hypercoagulability
Calcium oxalate
Calcium phosphate
Cystine
Struvite
Uric acid
Treatment for renal calculi?
Flomax, pain meds, surgical procedures, lithotripsy, cystoscopy, and so on.
Describe renal vein thrombosis
Causes: trauma, extrinsic compression, renal cell cancer, pregnancy, contraceptive use, and nephrotic syndrome
Manifestations: flank pain, hematuria, or nephrotic syndrome
Treatments: Anticoagulation
What diagnostics test are available for glomeruloneprhitis?
Cystoscopy & renal biopsy
Treatment for nephrotic syndrome?
• Corticosteroids and cyclophosphamide
• Manage diabetes
• ACE inhibitor, ARB, diuretics
• Antihyperlipidemic drugs
Decrease in serum protein stimulates liver
• Anticoagulants
• Low-sodium, moderate protein diet; small, frequent meals
What causes renal calculi?
diet, excess amount of tea or fruit juices, protein, lots of salt, and so on.
What food should be restricted with renal calculi?
Purine, calcium, oxalate
Describe polycystic kidney disease
Affects both kidneys in men and women
Cortex and medulla filled with thin-walled cysts that destroy surrounding tissue by compression
Cysts are filled with fluid; may have blood or pus
Signs and symptoms develop at 30 to 40 years of age
Clinical manifestations (initial): HTN; hematuria; pain or heavy feeling in back, side or abdomen; UTI or urinary stones; may be asymptomatic
Most common problem: chronic, severe pain
Treatment for glomerulonephritis?
Treatments: correct fluid overload, HTN, uremia, and injury to kidney
• Corticosteroids, cyclophosphamide
• Plasmapheresis
• Dialysis and transplant
Nursing management for nephrotic syndrome?
Nursing: manage edema; provide support
• Daily weights, accurate I & O, measure abdomen or extremities
• Avoid infection
What are the clinical manifestations of renal calculi?
First symptom—sudden, severe pain (renal colic)
Flank area, back, or lower abdomen
Ureter stretches, dilates, and spasms
May see: nausea and vomiting; “kidney stone dance;” dysuria, fever, chills; moist, cool skin
Describe adult PKD
Kidneys are enlarged; may be palpable
Affects other structures: liver, heart, blood vessels, intestines, and brain
Diagnostic studies: ultrasound or CT scan
Also consider: clinical findings and family history
Treatment: no cure
Prevent or treat UTI
Nephrectomy
Dialysis and kidney transplant
Nursing: management for ESRD; genetic counseling
How big is to big for a renal calculi?
4 mm or less can pass spontaneously
7 mm or more needs to be busted up