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Renal Vascular Disorder

Renal Vascular Disorders


Presentation

  • Symptoms of renal vascular disease vary depending on the type of disease and degree of involvement present. Renal Artery Stenosis High blood pressure that doesn’t get better with 3 or more medicines.[hopkinsmedicine.org]
  • : hematuria and flank pain Sudden onset of flank pain and hematuria Sickle cell nephropathy page 412 0 page 413 Sickle cell trait/disease: hematuria; loss concentration; renal papillary necrosis, APN Occurs with sickle cell trait or disease Clinical presentations[memorize.com]
  • Patients usually present with hypertension and varying degrees of renal impairment, although silent renal artery stenosis may be present in many patients with vascular disease.[bmj.com]
  • These are surgical emergencies and immediate presentation to the emergency department is warranted. These conditions present with sudden onset of severe constant abdominal pain that may be associated with vomiting, diarrhoea and fever.[northernsydneyvascular.com.au]
  • Presentation The condition may present in a variety of ways and is usually asymptomatic. The following clinical scenarios are relatively common modes of presentation: Hypertension: Abrupt onset of hypertension in middle-aged or older patients.[patient.info]
Inflammation
  • Culturally Sensitive Care 51 Legal and Ethical Aspects of Health Care 69 Nursing of Adults Across the Life Span 89 Palliative Care 109 Health Assessment 135 Genetics Genomics and the Multiple Determinants of Health 155 Stress Coping and Adaptation 191 Inflammation[books.google.com]
  • Lupus nephritis This inflammation of the kidney is caused by lupus, an autoimmune disease wherein the body’s immune system attacks its own cells and organs.[texaskidneycare.com]
  • It is characterized by fever, lymphadenopathy and inflammation of mucous membranes, skin and arteries: mainly coronary, axillary and iliac.[kidneypathology.com]
Hypertension
  • (no RBC casts) Renal azotemia Malignant hypertension page 411 0 page 412 Epidemiology Sudden onset of accelerated hypertension (1) May occur in normotensive individuals (2) May occur in those with BNS (most common) (3) May occur as a complication of[memorize.com]
  • Assessment of Cardiovascular and Hematological Function 579 Coronary Artery Dysfunction Nursing Management 609 Heart Failure and Inflammatory Dysfunction Nursing Management 643 Arrhythmias Nursing Management 671 Vascular Dysfunction Nursing Management 703 Hypertension[books.google.com]
  • […] secondary to other renal disorders I15.2 Hypertension secondary to endocrine disorders I15.8 Other secondary hypertension I15.9 Secondary hypertension, unspecified I16 Hypertensive crisis I16.0 Hypertensive urgency I16.1 Hypertensive emergency I16.9[icd10data.com]
  • Secondary hypertension is a type of hypertension with an underlying, potentially correctable cause.[aafp.org]
Family History of Heart Disease
  • High cholesterol, diabetes, being overweight, and having a family history of heart disease are also risk factors for RAS. High blood pressure is both a cause and a result of RAS. Renal artery thrombosis.[hopkinsmedicine.org]
  • These include: a diet high in fat, sodium, and sugar diabetes family history of heart disease high cholesterol obesity sedentary lifestyle, or a lack of exercise smoking Decreased blood flow through your renal arteries can increase your overall blood[healthline.com]
  • High cholesterol, high triglycerides, diabetes, too much weight, and a family history of heart disease are also risk factors for RAS. High blood pressure is both a cause and a result of RAS. Renal artery thrombosis.[massgeneral.org]
Contusion
  • 593.81 has the following ICD-9-CM references to the Index of Diseases and Injuries Crisis renal 593.81 Embolism 444.9 artery 444.9 renal 593.81 kidney (artery) 593.81 renal (artery) 593.81 vein 453.3 Hematoma (skin surface intact) (traumatic) - see also Contusion[healthprovidersdata.com]
  • […] renal 593.81 retinal (see also Occlusion, retina) 362.30 septic 449 specified site NEC 444.89 vertebral (see also Occlusion, artery, vertebral) 433.2 kidney (artery) 593.81 renal (artery) 593.81 Hematoma (skin surface intact) (traumatic) - see also Contusion[icd9data.com]
Skin Lesion
  • […] damage to arterioles and small arteries Gross and microscopic changes (1) Fibrinoid necrosis and necrotizing arteriolitis and glomerulitis Pinpoint hemorrhages on the cortical surface ("flea-bitten" kidneys) (2) Hyperplastic arteriolosclerosis ("onion skin[memorize.com]
  • lesions or red or purple color of the skin.[hopkinsmedicine.org]
  • […] hypertension may be present in up to 90 percent of persons with a renal artery aneurysm dissecting aneurysms (caused by a tear in the inner layer of the artery wall) may cause flank pain and blood in the urine Symptoms of Atheroembolic Renal Disease: skin[surgery.med.miami.edu]
  • Renal artery aneurysm Often no symptoms High blood pressure Flank pain and blood in the urine if a tear in the aneurysm Atheroembolic renal disease Skin lesions or red or purple color of the skin Discolored areas of the toes and feet Kidney failure Belly[massgeneral.org]
Skin Discoloration
  • Discolored areas of the toes and feet Kidney failure Belly pain Diarrhea Confusion Weight loss Fever Muscle aches Renal Vein Thrombosis Slow Onset Most often causes no symptoms Sudden Onset On-going severe flank pain with spasms at times Soreness over[hopkinsmedicine.org]
  • Renal artery aneurysm Often no symptoms High blood pressure Flank pain and blood in the urine if a tear in the aneurysm Atheroembolic renal disease Skin lesions or red or purple color of the skin Discolored areas of the toes and feet Kidney failure Belly[massgeneral.org]
Purpura
  • […] those with BNS (most common) (3) May occur as a complication of various disorders Risk factors (1) Pre-existing BNS (most common) Malignant hypertension: pre-existing BNS most common cause (2) Hemolytic-uremic syndrome (3) Thrombotic thrombocytopenic purpura[memorize.com]
  • Thrombotic thrombocytopenic purpura. J Thromb Haemost. 2005;3:1663-75. PubMed link Lowe EJ, Werner EJ. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome in children and adolescents. Semin Thromb Hemost. 2005;31:717-30.[kidneypathology.com]
  • […] present in up to 90 percent of persons with a renal artery aneurysm dissecting aneurysms (caused by a tear in the inner layer of the artery wall) may cause flank pain and blood in the urine Symptoms of Atheroembolic Renal Disease: skin lesions such as purpura[surgery.med.miami.edu]
Papilledema
  • Smooth muscle hyperplasia and reduplication of basement membrane Clinical findings Malignant hypertension: 210/120 mm Hg, encephalopathy, renal failure Rapid increase in blood pressure to 210/120 mm Hg Hypertensive encephalopathy (1) Cerebral edema (2) Papilledema[memorize.com]
  • Malignant hypertension is defined by rapid damage (or acute) of one or several target organs (with papilledema), rather than an exact number of blood pressure.[kidneypathology.com]
Encephalopathy
  • , renal failure Rapid increase in blood pressure to 210/120 mm Hg Hypertensive encephalopathy (1) Cerebral edema (2) Papilledema Loss of the normal optic nerve disk margin (3) Retinopathy Flame hemorrhages, exudates (4) Potential for an intracerebral[memorize.com]
Myelopathy
  • Postural hypotension in a patient with cervical myelopathy due to craniocervical anomaly. Cli Auton Res 1997 ;7(5):223-226. Steyn K, Thomas AG, Bradshaw, Laubscher R and Fourier J.[biomed.uninet.edu]
Kidney Failure
  • If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure.[ufhealth.org]
  • Dialysis access is a procedure reserved for people with kidney failure who depend on dialysis to survive.[scripps.org]
  • If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure. Call your provider if: You stop producing urine You feel sudden, severe pain in the back, flank, or abdomen.[medlineplus.gov]
  • In some cases, renal artery disease may be entirely asymptomatic (not associated with any symptoms).In severe cases, renal artery disease may lead to kidney failure. Symptoms of kidney failure include weakness, shortness of breath and fatigue.[my.clevelandclinic.org]
Flank Pain
  • Renal infarction: hematuria and flank pain Sudden onset of flank pain and hematuria Sickle cell nephropathy page 412 0 page 413 Sickle cell trait/disease: hematuria; loss concentration; renal papillary necrosis, APN Occurs with sickle cell trait or disease[memorize.com]
  • Discolored areas of the toes and feet Kidney failure Belly pain Diarrhea Confusion Weight loss Fever Muscle aches Renal Vein Thrombosis Slow Onset Most often causes no symptoms Sudden Onset On-going severe flank pain with spasms at times Soreness over[hopkinsmedicine.org]
  • […] pain Diarrhea Nausea, vomiting Confusion Weight loss Fever Muscle aches Renal vein thrombosis Slow onset: Most often no symptoms Sudden onset: On-going severe flank pain with spasms at times Soreness over the kidney, between the ribs and the backbone[massgeneral.org]
  • pain that may be spasmodic (with spasms) at times soreness in the area over the kidney, between the ribs and the backbone decreased kidney function The symptoms of renal vascular disease may resemble other medical conditions or problems.[surgery.med.miami.edu]
Oliguria
  • In general, but not invariably, the second of these phases is characterized by a low output of urine ( oliguria) and the third by an increasing urine output (polyuria).[britannica.com]
  • STEC-HUS : This form, also called the classical form, presents after or during an episode of diarrheal disease, there is acute renal failure with oliguria, proteinuria, hematuria, anemia and thrombocytopenia.[kidneypathology.com]

Workup

Small Kidney
  • BNS: kidney of essential hypertension; due to hyaline arteriolosclerosis Causes tubular atrophy, interstitial fibrosis, glomerular sclerosis Small kidneys with a finely granular cortical surface (Fig. 19-12) Laboratory findings Mild proteinuria Hematuria[memorize.com]
  • kidney compared to a normal sized one on the other side.[medicinenet.com]
Abnormal Renal Function
  • renal function, or volume overload Epidemiology prevalence 7% in the United States present in up to 1/3 of patients with malignant or resistant hypertension demographics atherosclerotic disease patients 50 years of age fibromuscular dysplasia young women[medbullets.com]
  • Functional aspects Effects of abnormal renal function on body fluid Renal disease in its diverse forms can lead to bodily deficits or excesses of water, sodium, potassium, and magnesium, and also to protein deficits occasioned by great losses of protein[britannica.com]
Fibrinoid Necrosis
  • ) Malignant hypertension: pre-existing BNS most common cause (2) Hemolytic-uremic syndrome (3) Thrombotic thrombocytopenic purpura (4) Systemic sclerosis Pathogenesis Vascular damage to arterioles and small arteries Gross and microscopic changes (1) Fibrinoid[memorize.com]
  • Cortical radial artery with fibrinoid necrosis of its wall (blue arrows) and inflammatory cells in the middle of this fuschinofílic material (red).[kidneypathology.com]

Treatment

  • 3) Retinopathy Flame hemorrhages, exudates (4) Potential for an intracerebral bleed Oliguric acute renal failure Laboratory findings Azotemia with BUN:Cr ratios 15 Hematuria with RBC casts Proteinuria Malignant hypertension: IV nitroprusside Initial treatment[memorize.com]
  • treatment options for vascular diseases.[loyolamedicine.org]
  • Treatment of Atheroembolic Renal Disease: Treatment of atheroembolic renal disease depends on the extent of the disease and the individual situation.[surgery.med.miami.edu]
  • Type of renal vascular disease Treatment Renal artery stenosis Medical treatment: Blood pressure lowering medicines to treat high blood pressure Medicines to lower cholesterol for atherosclerosis Treatment of related medical conditions such as diabetes[massgeneral.org]

Prognosis

  • Treatment and prognosis treatment of nephrotic syndrome: steroids and immune-suppression therapy treatment of underlying renal cell cancer includes surgery for early-stage disease anticoagulation therapy Complications Recognized complications of renal[radiopaedia.org]
  • The prognosis is variable depending upon the severity of lesions, whether unilateral or bilateral, comorbidities and co-existing atherosclerotic disease, age and response to medical or surgical therapy.[patient.info]
  • Outlook (Prognosis) Damage caused by arterial occlusion may go away. However, in most cases, it is permanent. If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine.[ufhealth.org]
  • HUS cases in endemic outbreaks have a better prognosis. The severity of systemic hypertension and duration of anuria are also factors related to prognosis.[kidneypathology.com]
  • , and hypernatremia bilateral renal stenosis can lead to volume overload heart failure pulmonary edema Associated conditions other manifestations of atherosclerotic disease carotid artery disease lower extremity artery disease coronary heart disease Prognosis[medbullets.com]

Etiology

  • Therefore, all children with confirmed hypertension should have an evaluation for an underlying etiology that includes renal ultrasonography.[aafp.org]
  • There are numerous etiologies for bland thrombus, but it most commonly occurs in the hypercoagulable nephrotic syndrome.[radiopaedia.org]
  • RENAL INVOLVEMENT IN SYSTEMIC ARTERIAL HYPERTENSION Systemic arterial hypertension (high blood pressure - HBP) has been classified according to etiology in essential, primary or idiopathic (unknown cause) and secondary (caused by other conditions).[kidneypathology.com]
  • KTWS is an uncommon disease (only 310 cases have been published) due to a congenital malformation of the deep venous system with agenesis, hypoplasia or segmental atresia, the etiology is not clear however seems to be related with diffuse mesodermal abnormalities[biomed.uninet.edu]

Epidemiology

  • Causes tubular atrophy, interstitial fibrosis, glomerular sclerosis Small kidneys with a finely granular cortical surface (Fig. 19-12) Laboratory findings Mild proteinuria Hematuria (no RBC casts) Renal azotemia Malignant hypertension page 411 0 page 412 Epidemiology[memorize.com]
  • […] renal arteries this often causes renovascular hypertension grade 1 – RAS (Renal artery stenosis) with no clinical symptoms grade 2 – RAS with controlled hypertension grade 3 – RAS with resistant hypertension, abnormal renal function, or volume overload Epidemiology[medbullets.com]
  • Epidemiology [ 3 ] The prevalence of atherosclerotic renal artery stenosis is high - about 7% in individuals older than 65 years and about 50% in patients with diffuse arterial disease, and it is increasingly frequent in an ageing population.[patient.info]
  • Epidemiology of hypertensive kidney disease. Nat Rev Nephrol. 2011;7(1):11-21. [ PubMed link ] Hart PD, Bakris GL. Hypertensive nephropathy: prevention and treatment recommendations.[kidneypathology.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of unilateral renal artery stenosis provides a clear example of how hypertension develops.[bmj.com]
  • ., smoking and fatty diet) fibromuscular dysplasia kidney transplant patients high calcium or phosphorous levels high low-density lipoprotein cholesterol levels Pathophysiology pathophysiology narrowing of artery lumen due to atherosclerosis fibromuscular[medbullets.com]
  • Renal vascular generation of eicosanoids is altered in pathophysiological conditions such as hypertension, diabetes, metabolic syndrome and acute renal failure.[clinsci.org]
  • The propensity for angiotensin receptor blockers (ARBs) to affect GFR adversely is based on similar pathophysiology.[emedicine.medscape.com]
  • Provocative captopril tests should be applied only to hypertensive patients thought to have a moderate suspicion of RVHT based on the usual clinical clues. 16 Pathophysiology of RAS.[biomed.uninet.edu]

Prevention

  • Conditions that affect the blood flow through the kidneys can affect the function of the kidneys and should be treated promptly to prevent permanent damage or other complications.[hopkinsmedicine.org]
  • The goal is to prevent it from getting worse. Renovascular disease can't always be prevented, although its development can be slowed down by controlling conditions that can cause it, such as high blood pressure and diabetes.[medigoo.com]
  • Prevention In many cases, the disorder is not preventable. The most important way to reduce your risk is to stop smoking. People at risk for developing blood clots may need to take anti-clotting medicines.[ufhealth.org]
  • By detecting carotid arterial disease early, we can take quick action to prevent a stroke.[fayettevillevascular.com]
  • A stent may be inserted to prevent the artery from becoming blocked again and to improve blood flow.[wexnermedical.osu.edu]

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