Renal Vascular Disease Flashcards Preview

A - MSRA Renal and Urinary [17] > Renal Vascular Disease > Flashcards

Flashcards in Renal Vascular Disease Deck (21)
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1
Q

What is renal vascular disease?

A

An umbrella term used to describe causes of hypoperfusion in the kidneys

2
Q

What do the vast majority of cases of renovascular disease occur secondary to?

A

Atherosclerotic disease

3
Q

What % of cases of renal vascular disease occur secondary to atherosclerosis?

A

About 80%

4
Q

What are the other causes of renal vascular disease?

A
  • Renal vein thrombosis
  • Fibromuscular dysplasia
  • Embolism
  • Post-transplant renal artery stenosis
5
Q

How might renovascular disease present?

A
  • Hypertension
  • Decrease in renal function
  • Recurrent pulmonary oedema in absence of systolic impairment
6
Q

Describe the hypertension in renovascular disease?

A

Secondary hypertension, often resistant to medical therapy

7
Q

What causes hypertension in renovascular disease?

A

RAAS activation

8
Q

What might cause decrease in renal function with renovascular disease?

A

Risk factors or ACEi/ARB treatment

9
Q

What is the gold standard investigation in renovascular disease?

A

Angiography

10
Q

How might fibromuscular dysplasia present in renovascular disease?

A

‘Beads on a string’ appearance

11
Q

What is the role of renal ultrasound in renovascular disease?

A

Cannot confirm the diagnosis, but may show asymmetrical kidneys

12
Q

What does treatment of renovascular disease involve?

A
  • Optimising risk factors
  • Avoiding nephrotoxic agents
  • Managing hypertension
13
Q

When should angioplasty be offered in renovascular disease?

A
  • Flash pulmonary oedema

- Hypertension refractory to medical therapy

14
Q

What is haemolytic-uraemic syndrome (HUS)?

A

A microvascular renal disorder characterised by thrombotic angiopathy resulting in endothelial dysfunction

15
Q

Who does HUS affect?

A

Primarily children

16
Q

What % of cases of HUS are in children?

A

90%

17
Q

What is HUS in children often related to?

A

Gastroenteritis caused by a certain strain of E. Coli

18
Q

How does HUS present?

A

Often presents with bloody diarrhoea and abdominal pain in initial stages, which may progress to thrombocytopenia, jaundice, and renal failure

19
Q

What investigation should be done in HUS?

A

Blood film

20
Q

What may be found on blood film in HUS?

A

Schistocytes (erythrocyte fragmentation as a result of intravascular damage)

21
Q

How is HUS managed?

A

Condition usually resolves spontaneously with conservative management, however dialysis and plasma exchange needed in some patients