POLYCYSTIC

KIDNEY
DISEASE

1. Autosomal recessive
2.Autosomal dominant

SIGNS AND
SYMPTOMPS
Dull pain at the side of
abdomen and back
Blood in the urine
Frequent urine tract infection
High blood pressure (often
before cysts appear)
Upper abdominal discomfort
(liver and pancreatic cysts)

TREATMENT
Bp- controlled and treated
Kidney failure- supportive
therapy until end-stage is
reached when dialysis or
transplant is then required
Urine tract infection
treatment with antibiotics
Pain-analgesics are used.
Alternatively, surgery to
shrink or resect the cysts.

DIABETIC
NEPHROPATH
Y

CHARACTERI
STIC
Persistent albuminuria
(>300mg/l or 200ug/min)
Progressive decline in the
glomerular filtration rate
(GFR)
Elevated arterial blood
pressure

PATHOPHISIOL
OGY
There 3 major histologic changes
occur in the glomeruli
1. mesangial expansion is directly
induced by hyperglycemia
2.Thickening of the glomerular
basement membrane (GBM)
3.Glomerular sclerosis cause by
intraglomerular hypertension

ETIOLOGY
Exact cause unknown
Various postulated
mechanisms are
hyperglycemia

EPIDEMIOLOGY
50 % diabetis mellitus patient
Affect males and females equally
Rare with had diabetes 10-20
years with mean age reach end
stage kidney disease (ESKD) 60
years
Younger get diabetes better

SIGNS AND
SYMPTOMS
Frothy urine (signifying
protein in urine)
Leg swelling (worse after
walking and standing )
High blood pressure
Itching
Nausea and/or vomiting
Losing weight
Lethargy
Increased need to urinate at

TREATMEN
T
Good control of diabetes
Good control of bP (aiming for
<130/85 or lower in younger
patient)
Medication to decrease protein
excretion and preserve the
functions of kidneys
Lower protein diet
Treat any urine tract infection ?
(which is common in diabetics)

HYPERTENSIVE
NEPHROSCLEROSI
S

CHARACTERISTIC
Long-term essential
hypertension
Hypertensiveretinopathy
Left ventricular hypertrophy
Minimal proteinuria
Progressive renal
insufficiency

PATHOPHYSIOLOGY
MECHANISM
1.Glomerular ischemia
consequence of chronic
hypertension resulting in
narrowing of preglomerular
arteries and arterioles thus
reduce the glomerular blood
flow

2. Glomerular hypertension and

glomerular hyperfiltration
Hypertension causes some glomeruli
become sclerotic
As attempt to compensate the loss of
renal function , the remaining nephrons
undergo vasodilation of the
preglomerular arterioles and
experience an increase in renal blood
flow and glomerular filtration
Resulting in glomerular hypertension ,
glomerular hyperfiltration and

EPIDEMIOLOGY

Hypertensive nephrosclerosis
accounts for 1/3rd patients on
hemodialysis
Increasing with advancing ages
with peak development foe
ESRD in range 45-65 years

 Headache

SIGN AND
SYMPTOMS

Giddiness (sometimes
related to posture)
Neck discomfort
Easily tired
Nauseous and/or vomiting
Protein n urine

TREATMEN
T
Medications to control blood
pressure (anti-hypertensive)
Lowering of dietary salt
(2g/day)
Exercise regularly

URINARY
TRACT
INFECTIONS

SIGNS AND
SYMPTOMS
Painful urination (burning
sensation)
Hot and foul smelling urine
Blood in urine
Fever (sometimes with chills)
Painful lower abdomen
Increased urgency/frequency
of wanting to pass urine
Nausea and/or vomiting

Treatmen
t
Appropriate antibiotics
Drink plenyy of water