Vascular Diseases of the Kidney Management Treatment

Vascular Diseases of the Kidney

Regular and appropriate blood supply to the glom­erular capillary network is essential for the proper function of the kidneys. If the blood supply to the kidneyDiabetic Nephropathy and Renal complications of DM (Diabetes Mellitus). Read more ... » is hampered, there is fluid and salt disturbance in the body.

Vascular diseases of the kidney are:

• 1. AtherosclerosisAcute Myocardial Infarction (AMI) Causes PATHOPHYSIOLOGY and Etiology. Read more ... »
• 2. Hypertensive diseaseLeishmaniasis or Kala-azar vector-borne disease by protozoa called Leish­mania Diagnosis Treatment. Read more ... »
• 3. Embolic diseases
• 4. Inflammatory diseases
• 5. Hematologic disorders.

Thromboembolic diseases of the Kidney

• Thromboembolic diseases of the kiidney occur due to embolization of thrombus formed in any artery or the left ventricle.
• Thrombosis of major renalDiabetic Nephropathy and Renal complications of DM (Diabetes Mellitus). Read more ... » arteries or their branches may be due to trauma, atherosclerosis, arteritis.
• Emboli may also commonly originate in the left ven­tricle as in AMIAcute Myocardial Infarction (AMI) Causes PATHOPHYSIOLOGY and Etiology. Read more ... », bacterial endocarditis, non-infective endocarditisGram-Positive STAPHYLOCOCCAL Bacterial Infections Causes Diagnosis Treatment. Read more ... ».
• There is flank painChronic pancreatitis Causes Symptoms Diagnosis and Treatment. Read more ... », tenderness, feverThyrotoxic crisis or Thyroid storm. Read more ... », hematuriaDIAGNOSIS and Investigations OF SECONDARY HYPERTENSION. Read more ... », leu­kocytosis, nauseaNausea and Vomiting. Read more ... », vomitingNausea and Vomiting. Read more ... ».
• Lab findings are increased AST, LDH, alkaline phos­phatase.
• There is acuteLeishmaniasis or Kala-azar vector-borne disease by protozoa called Leish­mania Diagnosis Treatment. Read more ... » oliguria, hypertensionThyroid Disorders Examination and Laboratory tests. Read more ... ». DiagnosisLeishmaniasis or Kala-azar vector-borne disease by protozoa called Leish­mania Diagnosis Treatment. Read more ... » is by renal arteriographyCoronary Angiography -Indications of Coronary Arteriography (Angiography). Read more ... ».

Management

• · Surgical intervention
• · AnticoagulantDeep Vein Thrombosis Embolizations Antiplatelet Anticoagulant Treatment Therapy. Read more ... » therapy
• · Supportive therapy
• · Antihypertensives.

Atheroembolic disease of Renal arteries

• It is a part of systemic syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... » due to atheroscle­rotic plaques in aorta and other arteries.
• The atherosclerotic plaques embolise to the renal ar­teries and small arteries of the kidneys.
• It is common in the elderly.
• ClinicalLeishmaniasis or Kala-azar vector-borne disease by protozoa called Leish­mania Diagnosis Treatment. Read more ... » manifestations appear 1 day to 2 weeks after the embolization.
• There is fever, myalgia, headacheHeadache. Read more ... », and weight loss. There may be purple toes, gangrene of toe, and em­bolization to other parts, hypertension, renal insuffi-” ciency, oliguria and renal failure.

Treatment

• Dialysis, cholesterol-lowering agents, angiographyCoronary Angiography -Indications of Coronary Arteriography (Angiography). Read more ... », angioplasty of blocked vessels.

Renal vein thrombosis

• Thrombosis of one or both renal veins may occur in a patient of nephrotic syndrome, membranous glomerulopathy, carcinomas etc.
• There is proteinuria, fever, chills, tenderness in lum­bar region, leucocytocsis, hematuria, deterioration in renal function, hypertension, Fanconi-like syndrome.
• Diagnosis is by angiography, Doppler ultrasound, CT, M RI.

Treatment

• Anticoag u lation Streptokinase Nephrectomy Thrombectomy.

Renal artery stenosis (RAS)

• It is also called ischemic renal disease and it may be a part of end-stage renal disease in patients of ure­mia over 50 years of age.
• RAS may be the cause of hypertension in 5% of hypertensives.
• There is an atheromatous plaque at the origin of the renal artery.
• . Bilateral RAS may also be found, especially in elderly, hypertension, diabetes, atherosclerosis.
• There may be intrinsic structural abnormalities of the arterial wall especially in young women. This condi~ tion is called fibromuscular dysplasia.
• Diagnosis is by Doppler ultrasonography, ultrasound of kidneys, contrast angiography, intra-arterial digi­tal subtraction angiography.
• ACE inhibitorsHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... » with 99m Tc labeled DTPA or 99m Tc labeled MAG 3 renography, gadolinium 3D MR an­giography are new and very sensitive and specific tests.

Treatment

• Surgery
• Angioplasty of affected renal artery Angioplasty with stenting.

Arteriolar nephrosclerosis

• In patients of hypertension, there is renal arteriolar disease which leads to loss of nephron function called nephrosclerosis.
• Nephrosclerosis may be benignPheochromocytoma Clinical Features Diagnosis Treatment. Read more ... » or malignantPheochromocytoma Clinical Features Diagnosis Treatment. Read more ... ».

Benign arteriolar nephrosclerosis

• In hypertensives with blood pressureChronic Long-term Complications Of Diabetes Mellitus. Read more ... »> 150/ 90 mm Hg, especially in the early stages, the kidney size may be normal or reduced and the renal arteries may show atherosclerotic changes.
• The afferent arterioles are thick, with narrow lumens, with ischemic injury of glomeruli and tubules.
• On fundoscopy, there is narrowing of retinal arteries, and flame-shaped haemorrhages.
• There is cardiacCHRONIC CONSTRICTIVE PERICARDITIS Physical findings and Treatment. Read more ... » hypertrophy and congestive heartCHRONIC CONSTRICTIVE PERICARDITIS Physical findings and Treatment. Read more ... » failure.
• . Serum creatinine is raised and there is mild pro­teinuria.
• The GFR (Glomerular Filtration Rate) is normal.

Malignant arteriolar nephrosclerosis

• In long-standing hypertension, there may be a sud­den accelerated elevation of blood pressure with di­astolic blood pressure sometimes more than 130 mmHg, with papilledema, CNSPARSEEK YAVANI HYOSCYAMUS NIGER VEDNASTHAPAN (ANALGESIC) with MAADAK(NARCOTIC) properties works on CNS. Read more ... » manifestations, heart failureHeart Failure Causes Symptoms NYHA classification with Heart Failure Treatment. Read more ... », and renal insufficiency.
• The kidneys are full of haemorrhages and have a char­acteristic flea-bitten appearance (diffuse red spots).
• There is fibrinoid necorsis, thickening of vessel walls and necrotizing arteriolitis.
• Usually malignant hypertension occurs in the 3^rd or 4^thdecade.
• It is more common in men.
• There is giddinessDizziness cause diagnosis treatment. Read more ... », headache, blurring of vision, sei­zures, and altered consciousness.
• There may be heart failure and renal failure.
• Lab find­ings are increased serum creatinine, hematuria, prQ,­teinuria, RBC and WBC casts in urine, hypokalemia, metabolic alkalosisAcidosis & Alkalosis physiology with signs and symptoms. Read more ... », hemolytic anaemiaHemolytic Anaemia Classification Diagnosis And Treatment. Read more ... » and uraemia-.

Treatment

• Control of hypertension Management of uraemia.