The definition of kidney disease varies
some depending on the type and cause. Diabetic nephropathy is this
topic, but I would be remiss if I do not include more. According to
several sources, several causes must be considered in any definition.
IgA nephropathy - is the most
common glomerulonephritis throughout the world.
Acute glomerulonephritis is an
inflammatory disease of both kidneys predominantly affecting children
from ages two to 12. Chronic glomerulonephritis can develop over a
period of 10-20 years and is most often associated with other
systemic disease, including diabetes, malaria, hepatitis, or systemic
lupus erythematosus.
Acute glomerulonephritis is an
inflammation of the glomeruli, bundles of tiny vessels inside the
kidneys. The damaged glomeruli cannot effectively filter waste
products and excess water from the bloodstream to make urine. The
kidneys appear enlarged, fatty, and congested. Diabetic nephropathy
will be the discussion in the next blog, based on this definition.
For more information, please enter the
word 'glomerulonephritis' into the Search box of this medical dictionary. You may wish to use the medical dictionary for other
terms below, as some are dependent on a correct meaning. You may
wish to bookmark the dictionary as in future blogs, you may wish to
use it again.
Analgesics - 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. Specifically, long-term use
of the analgesic phenacetin has been linked to renal papillary
necrosis (necrotizing papillitis).
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.
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 -
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 - 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.[3] 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.
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