systemic diseases and the kidney dr i.sagiv m.d nephrology & hypertension services
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Systemic diseases and the kidney Dr I.Sagiv M.D Nephrology & Hypertension services Hadassah-Hebrew university medical center Jerusalem. Outline. Diabetes Liver Disease SLE Vasculitis Scleroderma Multiple myeloma (dysproteinemias) Pre-eclampsia Cancer HTN. Diabetic nephropathy. - PowerPoint PPT PresentationTRANSCRIPT
Systemic diseases and the kidney
Dr I.Sagiv M.D
Nephrology & Hypertension services
Hadassah-Hebrew university medical centerJerusalem
Outline Diabetes Liver Disease SLE Vasculitis Scleroderma Multiple myeloma
(dysproteinemias) Pre-eclampsia Cancer HTN
Diabetic nephropathy
Diabetic nephropathy
Stage I: Hyperfiltration
0-5yr
Stage II: GMB thickened no proteinuria
2-7yr
Stage III: microalbuminuria
~7yr
Stage IV: proteinuria
~15yr
Stage V: ESRD
~25yr
Diabetic nephropathy
Diabetic nephropathy-Therapy
Control blood sugar HgA1c 6.5-7-7.5
Control Hypertension <130/80
ACE inhibitors/ARB’s
Diet
Liver Disease & Kidney
Glomerulonephritis assciated with: HBV (membranous)
HCV (cryoglobulinemia)
Hepato-renal syndrome
Hepato-renal syndrome
Reversible & functional renal failure.
Advanced hepatic failure (acute/chr) with cirrhosis and portal HTN.
Vasoactive abnormalities:
Splanchnic vasodilatation Renal vasoconstriction GFR
Hepato-renal syndrome-Therapy
Vasopressors
Liver transplantation
Systemic lupus erythematosus
Lupus nephritis III
Lupus nephritis IV
Lupus nephritis crescentic
Lupus nephritis- Therapy Immunosuppressants:
Steroids Azathioprine (Imuran) Cyclophosphamide Mycophenolate (cellcept) Biologic agents
Systemic sclerosis (scleroderma)
Scleroderma renal crisis
Leading cause of death (in the past).
ACE inhibitors
Multiple myeloma (& dysproteinemias)
Multiple myeloma
Hypertension
Hypertension & kidney disease