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Renal Vascular Diseases
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Thrombotic Microangiopathy
Cause: Complement dysregulation, drug toxicity, infections. Clinical presentation: Microangiopathic hemolytic anemia, thrombocytopenia, renal impairment. Diagnostic approach: Blood smear, ADAMTS13 activity, kidney biopsy. Treatment: Plasma exchange, immunosuppression, treat underlying condition.
Renal Artery Stenosis (RAS)
Cause: Atherosclerosis or fibromuscular dysplasia. Clinical presentation: Hypertension, decreased renal function. Diagnostic approach: Duplex ultrasound, angiography, MRA, CTA. Treatment: Revascularization (angioplasty with or without stent), antihypertensive therapy.
Renal Infarction
Cause: Embolism, thrombosis, vasculitis. Clinical presentation: Sudden flank pain, nausea, fever. Diagnostic approach: CT scan with contrast, MRI, laboratory tests (increased LDH). Treatment: Anticoagulation, address underlying condition, pain management.
Atheroembolic Renal Disease
Cause: Cholesterol crystal embolization post vascular procedures. Clinical presentation: Hypertension, renal insufficiency, skin lesions (livedo reticularis). Diagnostic approach: Elevated ESR, kidney biopsy. Treatment: Statins, manage cardiovascular risk, supportive care.
Fibromuscular Dysplasia
Cause: Idiopathic, affects medium-sized arteries. Clinical presentation: Hypertension, headache, abdominal bruit. Diagnostic approach: Angiography, duplex ultrasound. Treatment: Angioplasty, medical therapy, monitoring.
Hypertensive Nephrosclerosis
Cause: Chronic uncontrolled hypertension. Clinical presentation: Gradual renal function decline, proteinuria. Diagnostic approach: Ultrasound to assess for symmetrical kidney size, urine analysis, blood tests. Treatment: Blood pressure control, renin-angiotensin-aldosterone system (RAAS) blockers.
Renal Artery Aneurysm
Cause: Atherosclerosis, connective tissue disorders, trauma. Clinical presentation: Often asymptomatic, flank pain, hematuria. Diagnostic approach: Ultrasound, CT angiography, MRA. Treatment: Observation, endovascular repair, surgical resection.
Renal Vein Thrombosis (RVT)
Cause: Hypercoagulability, nephrotic syndrome, trauma. Clinical presentation: Flank pain, hematuria, kidney dysfunction. Diagnostic approach: Doppler ultrasound, CT scan, MRI. Treatment: Anticoagulants, thrombectomy, manage underlying cause.
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