Not to be confused with Neuropathy.
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This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (April 2008) |
| Nephropathy |
| Classification and external resources |
| Specialty |
urology |
| ICD-10 |
N00- N29 |
| MeSH |
D007674 |
Kidney disease, also known as Nephropathy, means damage to or disease of a kidney. Nephrosis is non-inflammatory nephropathy. Nephritis is inflammatory kidney disease.
Contents
- 1 Causes
- 1.1 Analgesics
- 1.2 Diabetes
- 1.3 IgA nephropathy
- 1.4 Iodinated contrast media
- 1.5 Lithium
- 1.6 Xanthine oxidase deficiency
- 1.7 Polycystic Disease of the Kidneys
- 1.8 Toxicity of Chemotherapy Agents
- 2 Development
- 3 Transplants
- 4 References
- 5 See also
Causes
Causes of kidney disease include deposition of the IgA antibodies in the glomerulus, administration of analgesics, xanthine oxidase deficiency, toxicity of chemotherapy agents, 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.
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).
Diabetes
Main article: Diabetic nephropathy
Diabetic nephropathy is a progressive kidney disease caused by angiopathy of the capillaries in the glomeruli. It is characterized by nephrotic syndrome and diffuse scarring of the glomeruli. It is particularly associated with poorly managed diabetes mellitus and is a primary reason for dialysis in many developed countries. It is classified as a small blood vessel complication of diabetes.[1]
IgA nephropathy
Main article: IgA nephropathy
IgA nephropathy is the most common glomerulonephritis throughout the world [2] 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.
Iodinated contrast media
Main article: Iodinated contrast media
Kidney disease induced by iodinated contrast media (ICM) is called CIN (= contrast induced nephropathy) or contrast-indueced AKI (= Acute kidney injury). Currently, the underlying mechanisms are unclear. But there is a body of evidence that several factors including apoptosis-induction seem to play a role.[3]
Lithium
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This article does not cite any references (sources). Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (November 2015) |
Main article: Lithium-induced nephropathy
The long term use of lithium, a medication commonly used to treat bipolar disorder and schizoaffective disorders, is known to cause nephropathy.[citation needed]
Xanthine oxidase deficiency
Main article: Xanthine oxidase deficiency
Another possible cause of Kidney disease 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. Xanthine oxidase inhibitors, like allopurinol, can cause 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 Kidney 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.
Toxicity of Chemotherapy Agents
Main article: Onconephrology
Nephropathy can be associated with some therapies used to treat cancer. The most common form of kidney disease in cancer patients is Acute Kidney Injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. Several chemotherapeutic agents, for example Cisplatin, are associated with acute and chronic kidney injuries.[4] Newer agents such as anti Vascular Endothelial Growth Factor (anti VEGF) are also associated with similar injuries, as well as proteinuria, hypertension and thrombotic microangiopathy.[5]
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. The process of most kidney diseases is renal Insufficiency, renal failure, and then uremia.
Transplants
Millions of people across the world suffer from kidney disease. Of those millions, several thousand will eventually or do need kidney transplants.[6] Out of those millions in the world, 16,500 in the United States needed a kidney transplant in 2008.[7] Of those 16,500 people, 5,000 of them died while waiting for a transplant.[8] Currently, there is a shortage of donors, and in 2007 there were only 64,606 kidney transplants in the world. [9] This shortage of donors is causing countries to place monetary value on kidneys. Countries such as Iran and Singapore are eliminating their lists by paying their citizens to donate. Also, the black market accounts for 5-10 percent of transplants that occur worldwide.[10] The act of buying an organ through the black market is illegal in the United States.[11] To get on the waiting list for a kidney transplant, patients must first get a referral from a physician, and then they must choose and contact a donor hospital. Once they choose a donor hospital, patients must then receive an evaluation to make sure they are sustainable to get a transplant. In order to be a match for a kidney transplant, patients must match blood type and human leukocyte antigen factors with their donors. They must also have no reactions to the antibodies from the donor’s kidneys.[1] [12]
References
- ^ Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p.2982
- ^ D'Amico, G (1987). "The commonest glomerulonephritis in the world: IgA nephropathy.". Q J Med 64 (245): 709–727. PMID 3329736.
- ^ Idee, J.-; Boehm, J.; Prigent, P.; Ballet, S.; Corot, C. (2006). "Role of Apoptosis in the Pathogenesis of Contrast Media-induced Nephropathy and Hints for its Possible Prevention by Drug Treatment". Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry 5 (2): 139. doi:10.2174/187152306776872442.
- ^ Portilla D, Safar AM, Shannon ML, Penson RT. Cisplatin nephrotoxicity. In: UpToDate, Palevsky PM (Ed), UpToDate, Waltham, MA, 2013. http://www.uptodate.com/contents/cisplatin-nephrotoxicity
- ^ Robinson, Emily S.; Khankin, Eliyahu V.; Karumanchi, S. Ananth; Humphreys, Benjamin D. (1 November 2010). "Hypertension Induced by Vascular Endothelial Growth Factor Signaling Pathway Inhibition: Mechanisms and Potential Use as a Biomarker". Seminars in Nephrology 30 (6): 591–601. doi:10.1016/j.semnephrol.2010.09.007. PMC 3058726. PMID 21146124.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
- ^ Scheve, Tom. "How Organ Donations Work". HowStuffWorks. Retrieved 9 March 2015.
- ^ Tabarrok, Alex (January 8, 2010). The Meat Market. Wall Street Journal.
See also
- Chronic kidney disease
- Hematologic Diseases Information Service
- Mesoamerican nephropathy, an enigmatic chronic kidney disease of Central America
- Nephritis
- IgA nephropathy
- Protein toxicity
- Proteinuria
- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
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| Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
| Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
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| Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
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| By condition |
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Primarily
nephritic,
RPG |
| Type I RPG/Type II hypersensitivity |
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| Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
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| Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
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Tubulopathy/
tubulitis |
| Proximal |
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| Thick ascending |
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| Distal convoluted |
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| Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
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| Renal papilla |
|
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| Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
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| Any/all |
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|
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| Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
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| Any/all |
| General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
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| Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
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| Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
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| Ureter |
- Ureteritis
- Ureterocele
- Megaureter
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| Pelvic |
| Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
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| Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
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| Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
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Index of the urinary system
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| Description |
- Anatomy
- Physiology
- Development
- Cells
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| Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
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| Treatment |
- Procedures
- Drugs
- Intravenous fluids
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