Sickle cell nephropathy notes

Background
 Medulla
Easy to understand hypoosmotic urine- abs solute
w/o water. In descending and thick ascenidng
countercurrent multiplication for hyperosmotic
urine. NaCl) is reabsorbed w/o water from AL into
medullary interstitium. decreases the
osmolality in tubules, ra ises interstitiumwater
reabs from descending limb
Vasa recta necessary to transport solutes and h2o
to maintain gradient
 Hematuria from venous engorgment and
ruptured vessels
Proteinuria, 40% have nephrotic syndrome,
from glomerular HTN. Also from RVT
Acute renal failure with good outlook
Hotn- ?slat losing, decreased vascular tone.
Therefore normotensive may actually be
dangerous- risk of stroke, mortality
 epsilon-aminocaproic acid