Acute Renal Conditions Flashcards
What electrolyte and metabolic disturbance occurs in renal tubular acidosis?
Hyperchloraemic metabolic acidosis.
Hypokalaemia in Type 1, 2 and 3.
Hyperkalaemia in Type 4.
A patient develops N&V and calcium-based renal stones.
U&Es reveal hypokalaemic hyperchloraemic metabolic acidosis.
What is the likely diagnosis?
Type 1 renal tubular acidosis
What are the causes of renal tubular acidosis type 1? (5)
CTDs: RA, SLE, Sjrogen’s
Amphotericin B toxicity
Analgesic neuropathy
A patient develops N&V and osteomalacia.
U&Es reveal hypokalaemic hyperchloraemic metabolic acidosis.
What is the likely diagnosis?
Type 2 renal tubular acidosis
What are the causes of renal tubular acidosis type 2? (5)
Facounaci syndrome
Wilson’s
Cystinosis
Old tetracyclines
CA inhibitors
What are the causes of renal tubular acidosis type 4? (2)
Hypoaldosteronism
Diabetes
A patient develops an AKI.
Muddy brown casts are seen on urine microscopy.
What is the likely diagnosis?
Acute tubular necrosis
What are the common causes of acute tubular necrosis? (6)
Ischaemia - shock, sepsis
Nephrotoxins - aminoglycosides, myoglobin (rhabdomyolysis), radiocontrast, lead
How may a pre-renal AKI be differentiated from acute tubular necrosis?
Pre-renal causes a high serum osmolality, ATN causes a low serum osmolality
Pre-renal responds well to fluid challenge, ATN does not respond well to fluid challenge
Pre-renal causes a high specific gravity, ATN causes a low specific gravity
What are the 3 clinical phases of acute tubular necrosis?
1 - oligouric
2 - polyuric
3 - recovery
A patient presents with acute fever, eosinophilia, AKI and hypertension.
What is the likely diagnosis?
Acute interstitial nephritis
What may be seen on urine microscopy in acute interstitial nephritis? (2)
Sterile pyuria
White-cell casts
Acute interstitial nephritis can be caused by drugs, systemic disease and infection.
List 3 of the drugs and 3 of the systemic diseases.
Drugs - penicillin, rifampicin, NSAIDs, allopurinol, furosemide
Diseases - SLE, sarcoidosis, Sjrogen’s
