09.2 Presentation of Kidney Diseases

Question 1

What is tubular proteinuria?

Answer 1

Low molecular weight proteins that are filtered and normally reabsorbed by the PCT aren’t so get excreted.

Question 2

What is overflow proteinuria?

Answer 2

Overproduction of small proteins that are filtered at a rate that is greater than Tm

Question 3

What is nephrotic syndrome?

Answer 3

Where proteinuria is sufficient enough to cause hypoalbuminaemia and therefore oedema.

Question 4

What happens in proteinuria that is enough to lower serum albumin but not directly cause oedema?

Answer 4

Oncotic pressure is lowered so water leaves the ECF, this lowers the circulating volume.
The RAAS system is activated which retains salt and water which leads to oedema.
(This can be the primary cause of the oedema and not the serum albumin being low enough to cause oedema directly)

Question 5

What is haematuria?

Answer 5

Blood in urine.
Result of bleeding anywhere from the glomerulus to the urethra.
UTI is the most common cause.

Question 6

What is nephrological haematuria?

Answer 6

Result of glomerular inflammation (glomeruloneprhitis) and bleeding.

Question 7

What is urological haematuria?

Answer 7

Bleeding caused by:
Renal stones
Renal cell carcinoma
Transitional cell carcinoma

Question 8

What symptoms would suggest a nephrological haematuria rather than a urological haematuria?

Answer 8

Abnormal renal function
Proteinuria
Salt and water retention - Hypertension
Young age (malignancy less likely)

Question 9

How would you investigate a haematuria?

Answer 9

Urine microscopy - Muddy brown casts are indicative of ATN (may not be used anymore)
Urine culture
Assess renal function (urea and creatinine)
Quantify protein excretion
Immunological tests
Renal imaging

Question 10

What is glomerular proteinuria?

Answer 10

Increase in permeability of the glomerulus to protein leading to abnormal filtration and excretion of protein.