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Renal Disease Information

Nephropathy refers to damage to or disease of the kidney. An older term for this is nephrosis.

Contents

Causes

Causes of nephropathy include deposition of the IgA antibodies in the glomerulus, administration of analgesics, xanthine oxidase deficiency, and long-term exposure to lead or its salts. Chronic conditions that can produce nephropathy include systemic lupus erythematosus, diabetes mellitus and high blood pressure (hypertension), which lead to diabetic nephropathy and hypertensive nephropathy, respectively.

IgA nephropathy

Main article: IgA nephropathy

IgA nephropathy is the most common glomerulonephritis throughout the world [1] Primary IgA nephropathy is characterized by deposition of the IgA antibody in the glomerulus. The classic presentation (in 40-50% of the cases) is episodic frank hematuria which usually starts within a day or two of a non-specific upper respiratory tract infection (hence synpharyngitic) as opposed to post-streptococcal glomerulonephritis which occurs some time (weeks) after initial infection. Less commonly gastrointestinal or urinary infection can be the inciting agent. All of these infections have in common the activation of mucosal defenses and hence IgA antibody production.

Analgesics

Main article: Analgesic nephropathy

One cause of nephropathy is the long term usage of analgesics. The pain medicines which can cause kidney problems include aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs, or NSAIDs. This form of nephropathy is "chronic analgesic nephritis," a chronic inflammatory change characterized by loss and atrophy of tubules and interstitial fibrosis and inflammation (BRS Pathology, 2nd edition).

Specifically, long term use of the analgesic phenacetin has been linked to renal papillary necrosis (necrotizing papillitis).

Xanthine oxidase deficiency

Main article: Xanthine oxidase deficiency

Another possible cause of nephropathy is due to decreased function of xanthine oxidase in the purine degradation pathway. Xanthine oxidase will degrade hypoxanthine to xanthine and then to uric acid. Xanthine is not very soluble in water; therefore, an increase in xanthine forms crystals (which can lead to kidney stones) and result in damage of the kidney. Drugs like allopurinol that are used to inhibit xanthine oxidase can therefore cause possible nephropathy.

Polycystic Disease of the Kidneys

Main article: Polycystic kidney disease

Additional possible cause of nephropathy is due to the formation of cysts or pockets containing fluid within the kidneys. These cysts get enlarged with the progression of aging causing renal failure. Cysts may also form in other organs including the Liver, Brain and Ovaries. Polycystic Disease is a genetic disease caused by Mutations in the PKD1, PKD2, and PKHD1 genes. This disease affects about half a million people in the US. Polycystic kidneys are susceptible to infections and cancer other factors contributing to renal failure.

Development

Kidney Disease is a chronic non-communicable disease, having serious consequence if it can not be controlled effectively. Generally, the process of Kidney Disease development is from light to serious. Most Kidney Diseases follow developing process of Renal Insufficiency, Renal Failure and Uremia.

References

  1. ^ D'Amico, G (1987). "The commonest glomerulonephritis in the world: IgA nephropathy.". Q J Med 64 (245): 709–727. PMID 3329736. http://qjmed.oxfordjournals.org/cgi/reprint/64/3/709.

See also

Urinary system · Pathology · Urologic disease / Uropathy (N00–N39, 580–599)
Abdominal
Nephropathy/ (nephritis+ nephrosis)
Glomerulopathy/ glomerulitis/ (glomerulonephritis+ glomerulonephrosis)
Primarily nephrotic
Non-proliferative Minimal change · Focal segmental · Membranous
Proliferative Mesangial proliferative · Endocapillary proliferative Membranoproliferative/mesangiocapillary
By condition Diabetic · Amyloidosis
Primarily nephritic, RPG
Type I RPG/Type II hypersensitivity Goodpasture's syndrome
Type II RPG/Type III hypersensitivity Post-streptococcal · Lupus (DPN) · IgA/Berger's
Type III RPG/Pauci-immune Wegener's granulomatosis · Microscopic polyangiitis
Tubulopathy/ tubulitis
Proximal RTA (RTA 2) · Fanconi syndrome
Thick ascending Bartter syndrome
Distal convoluted Gitelman syndrome
Collecting duct Liddle's syndrome · RTA (RTA 1) · Diabetes insipidus (Nephrogenic)
Renal papilla Renal papillary necrosis
Major calyx/pelvis Hydronephrosis · Pyonephrosis · Reflux nephropathy
Any/all Acute tubular necrosis
Interstitium Interstitial nephritis (Pyelonephritis, Danubian endemic familial nephropathy)
Any/all
General syndromes Renal failure (Acute renal failure, Chronic renal failure) · Uremic pericarditis · Uremia
Vascular Renal artery stenosis · Renal Ischemia · Hypertensive nephropathy · Renovascular hypertension · Renal Cortical Necrosis
Other Analgesic nephropathy · Renal osteodystrophy · Nephroptosis · Abderhalden-Kaufmann-Lignac syndrome
Ureter Ureteritis · Ureterocele · Megaureter
Pelvic
Bladder Cystitis (Interstitial cystitis, Hunner's ulcer, Trigonitis, Hemorrhagic cystitis) · Neurogenic bladder · Bladder sphincter dyssynergia · Vesicointestinal fistula · Vesicoureteral reflux
Urethra Urethritis (Non-gonococcal urethritis) · Urethral syndrome · Urethral stricture/Meatal stenosis · Urethral caruncle
Any/all Obstructive uropathy · Urinary tract infection · Retroperitoneal fibrosis · Urolithiasis (Bladder stone, Kidney stone, Renal colic) · Malacoplakia · Urinary incontinence (Stress, Urge, Overflow)

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