tubulointerstritial disease
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- acute interstitial nephritis
- acute renal failure, interstitial inflammatory cells, interstitial edema
- mechanism of AIN
-
allergic
due to drugs, infections, or idopathic (most cases) - chronic interstitial nephritis
- chronic renal failure, mixed inflammatory cells, tubular atrophy, fibrosis
- mechanism of CIN
-
physical or chemical with precipitation of substances into medulla
ischemic due to drug induced vasc change - causes of CIn
- drugs, NSAIDS, reflux nephropathy, stones, PCKD
- acute pyelonephritis
- infection involving parenchyma calyces and pelvis
- causes of Acute pyelonephritis
-
ureteral reflux affects pelvis 95%
hematogenous infection affects cortex 5% - who is predisposed to acute pyelonephritis
- pregnant women, diabets
- chronic pyelonephritis with reflux nephropathy
- multiple episodes of infection secondary to congenitally short intravesical ureter or obstruction
- thyroidization tubular atrophy
- chronic pyelonephritis with reflux nephropathy
- acute tubular necrosis
- acute renal failure secondary to tubular damge
- causes of acute tubular necrosis
-
ischemic
post transplant
shock
toxic
obstructive - phases of acute tubular necrosis
-
oliguric
diuretic
regenerative - who is predisposed to papillary necrosis
- long term analgesic users (acetominophen, phenacetin)
- ADPKD
- very large cystic kidneys, no dysplasia
- ARPKD
-
large smooth kidneys, narrow cysts perpendicular to capsule
rare - translucent systs on surface of cortex
-
benign simple cystic disease
no clinical significance - most common cause of abdominal mass in newborn
- multicystic renal dysplasia
- most common form of renal transplant rejection
-
acute cellular rejections
tubulitis, interstitial edema and inflammation - most common cause of graft loss
-
chronic allograft nephropathy
due to repeated subclinical episodes of acute cellular rejection - what causes characteristic nodular hyalinzation of arterioles and changes identical to chronic rejection?
- calcineurin inhibitor toxicity