Hormonal Dysfunction
this hormone is underproduced by damaged kidneys, leading to anemia in CKD
erythropoietin
What is the most common bacterium that causes UTI?
Uropathogenic E. coli (UPEC)
Due to Susan’s Type 2 Diabetes, what abnormality will be found in her urine?
Glycosuria/glucose in the urine
What is the most common cause of CKD, and also increases the risk of UTI?
T2DM
CKD disrupts activation of this vitamin, leading to low calcium and bone problems.
vitamin D
How can pyelonephritis lead to kidney disease?
Chronic pyelonephritis can cause enough tissue damage in the kidneys, specifically nephrons, to lead to significant decline in GFR, i.e. CKD
Define tubular secretion and reabsorption
Tubular secretion: filtration across the peritubular capillaries into the tubule; Tubular reabsorption: filtration across the tubule into the peritubular capillaries
What is the surgical connection that is created for haemodialysis called?
Arteriovenous fistula/A-V fistula
this hormone, made in the hypothalamus and released by the posterior pituitary, helps the kidneys reabsorb water
Antidiuretic hormone (ADH)
Name four anti-bacterial molecules at the mucosal surface that act as host defence
Lactoferrin, defensins, lysosomes, IgA, bactericidal zinc
In a healthy patient, what mechanism keeps GFR and renal blood flow constant over a wide range for MAP and what overrides this mechanism in Susan’s case?
Autoregulation - myogenic response + tubuloglomerular feedback; angiotensin II
How is end-stage kidney disease defined in terms of GFR?
GFR < 15mL/min
Name the condition caused by secondary hyperparathyroidism in CKD patients.
Renal osteodystrophy
Name four types of urine sample collection methods for babies/young children from worst to best (in terms of sample quality)
Bag urine, clean catch urine, catheterisation, suprapubic bladder aspiration
Describe the course of a red blood cell as it enters the renal artery, goes through a juxtamedullary nephron, and exits via the renal vein.
Renal artery → segmental artery → interlobar artery → arcuate artery → interlobular artery → afferent arteriole → glomerulus → efferent arteriole → vasa recta → interlobular vein → arcuate vein → interlobar vein → renal vein)
What is a non-modifiable risk factor Susan has for kidney disease?
indigenous heritage
This hormone system is often overactivated in CKD, contributing to hypertension.
Renin-angiotensin-aldosterone system (RAAS)
Name one virulence factor that helps UPEC stick to the bladder wall, and its function
FimH adhesin
binds to mannosylated uroplakins on the surface of umbrella cells, inducing actin rearrangement and internalisation of UPEC
How does the renin-angiotensin system contribute to oedema formation in patients with ESKD?
(ESKD = damaged nephrons → decreased blood flow to juxtaglomerular apparatus → baroreceptor mechanism = JG cells release renin → renin catalysis reaction of angiotensinogen to Angiotensin 1 → ACE catalyses reaction of Angiotensin 1 to angiotensin 2 = vasocontriction (increase in BP), aldosterone release (promotes sodium reabsorption, and thus water reabsorption), and ADH release (water reabsorption) → increase in hydrostatic pressure = fluid pushed out into interstitial space → oedema)
What is uraemia, and name an endocrine complication due to it.
Buildup of waste products in the blood due to decline in kidney function; anaemia, osteomalacia, HT