Info
🌱 來自: Huppert’s Notes
Other Diseases Affecting Renal Tubular Absorption🚧 施工中
Other Diseases Affecting Renal Tubular Absorption
Renal papillary necrosis
• Etiology: Poor medullary perfusion resulting in ischemia and necrosis. Most often bilateral. Caused by vascular disease (diabetes), vasoconstriction (NSAIDs), vascular occlusion (sickle cell).
• Treatment: Stop offending agent, treat the underlying disease
Hartnup Syndrome
• Etiology: Rare autosomal recessive inborn error of amino acid metabolism. Impaired amino acid absorption in the gut and proximal renal tubule causing variable losses of proteins (e.g., tryptophan).
• Clinical features: Variable. Can be similar to pellagra: Dermatitis, diarrhea, ataxia, psychiatric findings
• Diagnosis: Elevated amino acids in the urine
• Treatment: Supplemental nicotinamide if symptomatic
Fanconi Syndrome
• Etiology: Primary (idiopathic) or secondary proximal tubule dysfunction causing defective transport of glucose, amino acids, Na+, K+, phosphorus, uric acid, bicarb. Causes include genetic (Wilson’s disease, galactosemia), acquired damage from heavy metals, connective tissue disorders, hematologic malignancies (monoclonal gammopathy), and medications (tenofovir, carbonic anhydrase inhibitors).
• Clinical features: Glucosuria, phosphaturia (rickets, osteomalacia), proteinuria, polyuria, dehydration, hypercalciuria, hypokalemia
• Treatment: Treat the underlying cause if possible. Electrolyte and vitamin D supplementation may be required.