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MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

MLAB 2401: Clinical Chemistry Keri Brophy-Martinez. Pathophysiology of Renal Function. Glomerular Diseases. Associated with damage to the glomeruli of the nephron Lead to tubular dysfunction Can be acute or chronic. Acute Glomerulonephritis (AGN).

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MLAB 2401: Clinical Chemistry Keri Brophy-Martinez

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  1. MLAB 2401: Clinical ChemistryKeri Brophy-Martinez Pathophysiology of Renal Function

  2. Glomerular Diseases • Associated with damage to the glomeruli of the nephron • Lead to tubular dysfunction • Can be acute or chronic

  3. Acute Glomerulonephritis (AGN) • Characterized by rapid onset of symptoms that indicate damage to the glomeruli. • Population affected includes children and young adults

  4. Acute Glomerulonephritis (AGN) • Causes of: • AGN often follows a group A streptococcal infection • Circulating immune complexes trigger an inflammatory response in the glomerular basement membrane • Toxin/Drug-related exposures • Acute kidney infections • Systemic diseases

  5. Acute Glomerulonephritis (AGN) • Symptoms • Hematuria • Proteinuria • Oliguria • Fever • Malaise • Rapid Onset • Edema • Hypertension • Sodium & water retention • Laboratory Findings • Decreased GFR • Increased BUN & creatinine • Hyaline, granular, RBC casts • Increased protein in urine • Blood in urine

  6. Chronic Glomerulonephritis (CGN) • Associated with the end stage of persistent glomerular damage • Irreversible loss of renal tissue • Can result in renal failure • Symptoms of CGN include: • edema, fatigue, hypertension, metabolic acidosis, proteinuria, decreased urine volume

  7. Nephrotic Syndrome • Causes of: • Complications of glomerulonephritis • Circulatory disorders affecting kidneys • Hallmark • Increased permeability of glomerular basement membrane • Allows for proteins & lipids to enter GFR

  8. Nephrotic Syndrome • Symptoms: • Massive proteinuria (>3 g/day) • Albuminuria (>1.5 g/day) • Pitting edema • Hyperlipidemia • Hypoalbuminemia • Lipiduria: oval fat bodies

  9. Urinary Tract Infection • Causes of: • Pyelonephritis (kidneys) • Acute: no permanent damage • Chronic: permanent damage, possible renal failure • Cystitis (bladder) • Lab Findings • Positive nitrite on dipstick • Hematuria • Pyuria • WBC casts

  10. Obstructions • Causes of: • Renal calculi • Calcium oxalate most common • Tumors • Urethral strictures • Leads to chronic renal failure

  11. Renal Failure • Acute • Sudden decline in renal function • GFR < 10 mL/minute • Caused by nephrotoxic agents, necrosis, hemorrhaging • Hemolytic transfusions reactions • Burns • Cardiac failure • Antifreeze ingestions

  12. Renal Failure: Chronic (CKD) • Chronic • Gradual decline in function • Associated with hypertension and diabetes • Risk factors • Autoimmune diseases • Urinary tract and systemic infections • Some medications • Complications from CKD • Anemia • Hyperparathyroidism • Vitamin D deficiency/insufficiency • Mineral and bone disorders

  13. Dialysis • Method used to rid the body of waste products

  14. References • Bishop, M., Fody, E., & Schoeff, l. (2010). Clinical Chemistry: Techniques, principles, Correlations. Baltimore: Wolters Kluwer Lippincott Williams & Wilkins. • Sunheimer, R., & Graves, L. (2010). Clinical Laboratory Chemistry. Upper Saddle River: Pearson. • Vassalotti, MD, J. A., & Kaufman, MD, H. W. (2013, July). New Guidelines to Evaluate and manage Chronic Kidney Disease. MLO, 24-26.

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