Learning objectives
The purpose of the course is to prepare the student for:
1) understanding the pathophysiologic basis of principal renal and nephro-urologic diseases. 2) Identifying the elements featuring the above-mentioned illnesses, defining their main pathologic aspects and understanding the relationships among histologic damage, functional lesions and related symptoms. 3) Acquiring critical awareness of the indications and limits of clinical, instrumental and laboratory investigations.
Prerequisites
: Passing all pre-clinical exams
Course unit content
Diagnosis of renal disease.
primary and secondary glomerular nephropathies: pathogenetic, histological and clinical aspects; short notes of therapy. General aspects of renal protection.
Action of diuretics.
Acute and chronic tubulointerstitial diseases.
Nephrolithiasis: clinical and therapeutic aspects.
Cystic renal diseases.
Acute and chronic vascular renal diseases.
Acute renal failure.
Chronic renal failure.
Dialysis: physicochemical principles and main clinical problems.
Renal transplantation: fundamental aspects of genetics, immunology, pathology and therapy
Full programme
• Diagnosis of renal disease: proteinuria, hematuria, BUN.
• Creatinine clearance and glomerular filtration rate.
• Radiological examination.
• Glomerular nephropathy: clinical aspects and course. Clinico-pathological pictures:
• Acute post-infectious and post-streptococcal glomerulonephritis, rapidly progressive glomerulonephritis, membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, IgA nephropathy, Non IgA mesangial proliferative glomerulonephritis, Alport disease, familiar benign hematuria.
• Secondary glomerular nephropathies: general classification, diabetic nephropathy,lupus nephritis,
renal vasculitides (Wegener granulomatosis, micropolyangitis, Churg and Strauss disease, cryoglobulinemia, Henoch Schoenlein disease) deposition renal diseases (amyloidosis, multiple myeloma
• General aspects of renal protection.
• Disorders of hydration: hyponatremia and hypernatremia: pathophysiologic and clinical aspects.
• Volume disorders: pathophysiology of salt and water retention, pathogenesis of edema.
• Action of diuretics. Pathophysiology and clinical diagnosis of hypovolemia.
• Electrolyte imbalance: potassium and acid-base disorders.
• Acute and chronic tubulointerstitial disease of infectious and non-infectious origin.
• Nephrolithiasis.
• Cystic renal disease.
• Vascular renal disease: acute (thromboembolism) and chronic (nephroangiosclerosis).
• Acute renal failure: etiopathogenesis, clinical aspects, therapy.
• Chronic renal failure:
a) etiopathogenesis, clinical aspects, therapy;
b) complications: calcium phosphorus, hydroelectrolitic and acid base imbalance; anaemia,
cardiovascular disorders.
• Dialysis: physicochemical principles, indications, efficacy and limits, complications;
principal clinical problems in the dialyzed patient.
• Renal transplantation: epidemiology, indications and contraindications. Immunological and
therapeutical basis. Clinical aspects and complications: the surgical intervention and its complications; acute rejection; chronic allograft nephropathy. Immunosuppressive therapy:
general aspects and complications: infections, neoplasia, cardiovascular disorders. Other complications. Viral hepatitis and renal transplantation.
Bibliography
- Harrison's: Principles of Internal Medicine. McGraw-Hill Ed.
- Schena, Selvaggi et al.: Malattie dei Reni e delle vie Urinarie. Mc Graw Hill Ed.
-- Slides of all lessons and short texts on singular topics provided by the teacher
Teaching methods
: Oral and practical lessons
Assessment methods and criteria
Joined quiz and written exam
