reflux nephropathy


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nephropathy

 [nĕ-frop´ah-the]
1. any disease of the kidneys. adj., adj nephropath´ic.
2. any disease of the kidneys; see also nephritis. Called also nephrosis. adj., adj nephropath´ic.
AIDS nephropathy former name for HIV-associated nephropathy.
analgesic nephropathy interstitial nephritis with renal papillary necrosis, seen in patients with a history of abuse of analgesics such as aspirin or acetaminophen alone or in combination.
diabetic nephropathy the nephropathy that commonly accompanies later stages of diabetes mellitus; it begins with hyperfiltration, renal hypertrophy, microalbuminuria, and hypertension; in time proteinuria develops, with other signs of decreasing function leading to end-stage renal disease.
gouty nephropathy any of a group of chronic kidney diseases associated with the abnormal production and excretion of uric acid.
heavy metal nephropathy the kidney damage resulting from any of various forms of heavy metal poisoning, usually in the form of tubulointerstitial nephritis. The most common metals involved are cadmium, lead, and mercury.
HIV-associated nephropathy renal pathology in patients infected with the human immunodeficiency virus, similar to focal segmental glomerulosclerosis, with proteinuria, enlarged kidneys, and dilated tubules containing proteinaceous casts; it may progress to end-stage renal disease within weeks.
hypokalemic nephropathy nephropathy with hypokalemia, interstitial nephritis, swelling and vacuolization of proximal renal tubules, and progressive renal failure, resulting from conditions such as oncotic overloading of the kidney filtration mechanisms by sugars. See also potassium-losing nephropathy.
IgA nephropathy a chronic form marked by hematuria and proteinuria and by deposits of IgA immunoglobulin in the mesangial areas of the renal glomeruli, with subsequent reactive hyperplasia of mesangial cells. Called also Berger's disease and IgA glomerulonephritis.
ischemic nephropathy nephropathy resulting from partial or complete obstruction of a renal artery with ischemia, accompanied by a significant reduction in the glomerular filtration rate.
lead nephropathy the kidney damage that accompanies lead poisoning; lead deposits appear in the epithelium of the proximal tubules and as nuclear inclusions in cells. In time this leads to tubulointerstitial nephritis with chronic renal failure and other symptoms.
membranous nephropathy membranous glomerulonephritis.
minimal change nephropathy minimal change disease.
obstructive nephropathy nephropathy caused by obstruction of the urinary tract (usually the ureter), with hydronephrosis, slowing of the glomerular filtration rate, and tubular abnormalities.
potassium-losing nephropathy hypokalemic nephropathy after persistent potassium loss; it may be seen in metabolic alkalosis, adrenocortical hormone excess, or in intrinsic renal disease such as renal tubular acidosis or hyperplasia of juxtaglomerular cells. Called also potassium-losing nephritis.
reflux nephropathy childhood pyelonephritis in which the renal scarring results from vesicoureteric reflux, with radiological appearance of intrarenal reflux.
salt-losing nephropathy intrinsic renal disease causing abnormal urinary sodium loss in persons ingesting normal amounts of sodium chloride, with vomiting, dehydration, and vascular collapse. Called also salt-losing nephritis.
urate nephropathy (uric acid nephropathy) any of a group of kidney diseases occurring in patients with hyperuricemia, including an acute form, a chronic form (gouty nephropathy), and nephrolithiasis with formation of uric acid calculi.

re·flux ne·phrop·a·thy

damaged renal parenchyma secondary to vesicoureteral reflux of infected urine.

reflux nephropathy

Ureteral reflux, vesicoureteral reflux, vesicoureteric reflux Nephrology The retrograde flow of urine from the bladder into the ureters which occurs when the unidirectional valve-like flow between the ureters and bladder fails; bladder infection may cause pyelonephritis, and expose the kidney to high pressures, which over time damage the kidney and cause scarring Etiology Short or absent bladder wall tunnels, bladder infection, stones, bladder outlet obstruction, neurogenic bladder, abnormal ureters or number of ureters, following surgical reimplantation of ureters during kidney transplantation or due to ureteral trauma Clinical Repeated bladder infections Associations Cystits, stones, bladder outlet obstruction, structural defects of ureters Grading 5 grades; grades I and II don't require treatment Risk factors Personal or family Hx of reflux, congenital urinary tract defects, and recurrent UTIs Prognosis RN may lead to chronic renal failure, ESRD, nephrotic syndrome. See End-stage renal disease, Urinary tract infection.
References in periodicals archive ?
Since the main histological alteration in reflux nephropathy is renal fibrosis, Sabasinska et al.
On the other hand, based on the available data, we consider that the proinflammatory cytokines (IL-6 and TNF-[alpha]), the chemokine, CXCL8/IL-8, and the fibrogenic cytokine, TGF-[beta], should be more intensively evaluated as potential biomarkers for renal scarring and for the emergence of CKD in reflux nephropathy (Table 2).
Eremin, "Urinary cytokines as markers of reflux nephropathy," Journal of Urology, vol.
Orikasa, "Clinical significance of urinary interleukin-6 in children with reflux nephropathy," Journal of Urology, vol.
Reflux nephropathy, which also is called chronic nonobstructive pyelonephritis, is defined as reflux of urine from the urinary bladder through an incompetent vesicoureteral junction and into the ureter and pyelocaliceal system and, eventually, into the renal parenchyma, without mechanical obstruction of the urine outflow tract.
Urine reflux is primarily responsible for the renal injury in reflux nephropathy, but an element of urinary obstruction with hydronephrosis, which is frequent in the late phases of reflux nephropathy, aggravates the injury.
The kidney with reflux nephropathy has a broad spectrum of changes.
Patchy renal parenchymal affliction characterized by severe changes next to normal areas, or marked dilatation and tortuosity of the ureter indicates reflux nephropathy. The diagnosis of chronic pyelonephritis is suggested in the presence of "significant" chronic inflammation of both renal parenchyma and the pyeolocaliceal system (Figure 2, E).
These include (1) increased bacterial resistance;[sup.17] (2) the inconvenience and risk associated with serial radiologic investigations; (3) decreased cost-effectiveness;[sup.18] (4) the clinical versus statistical significance of any result;[sup.19] and (5) the fate of those refluxers who do not resolve over time, in that we are shifting the progression of chronic renal disease into adulthood given the known, slow progression of reflux nephropathy.
Although the exact pathogenesis of renal scarring is not well-understood, the end result, reflux nephropathy, is understood, and could be entirely preventable.
Until the role of antimicrobial prophylaxis is clarified, surgical intervention in the form of ureteral reimplantation remains the gold standard for the prevention of reflux nephropathy in susceptible renal units.