Approach to Renal and GU complaint Flashcards
What are the markers of kidney damage?
Protein in urine
Abnormal urinary sediment
Abnormal kidney biopsy
Abnormal renal imaging
Electrolyte abnormalities
hx of kidney transplant
If the GFR is less than this, you should be concerned about chronic kidney disease
60
**if it has been going on for more than 3 months, then the patient has acute kidney injury
What GFR defines CKD Stage 1
> 90
What GFR defines CKD Stage 2?
60-89 mild decrease in GFR
What GFR defines CKD Stage 3a?
45-59
mild to moderate decrease
What GFR defines CKD Stage 3b?
30-44
moderate to severe decrease
What GFR defines CKD Stage 4?
15-29
severe decrease
What GFR defines CKD Stage 5?
<15
Kidney failure/ESRD
What is the prevalence of CKD?
15% of the Us adults
What are the CKD risk factors?
DM
HTN
CVD
AKI
List the signs and symptoms of CKD?
edema HTN Decreased urine output Foamy urine Hematuria Uremia Pericardial friction rub Asterixis Uremic frost
What are the 3 “simple” tests to fully diagnose CKD?
eGFR
urine albumin to creatinine OR urine protein to creatinine ratio
urinalysis
What is expected to be found on an ultrasound for the CKD
atrophic or small kidneys
cortical thinning
Increased echogenicity
Elevated resistive indices
What will happen to serum creatinine rate as the GFR decreases?
The serum creatinine levels rise as GFR drops
What happens to the GFR after the age of 30-40?
declines by 1 ml/min/year
What are some of the complications of CKD?
CVD
Chronic kidney disease- mineral and bone disease
anemia of CKD
Electrolyte abnormalities
metabolic acidosis
volume overload
uremia
HTN
What are the indications for dialysis?
AEIOU
Acidosis
Electrolyte disturbance
Ingestion
Volume Overload
Uremia
This is the term for an elevated BUN without sx
Azotemia
This is the term for an elevated BUN with symptoms
Uremia
What are the stages of AKI based off of?
Serum creatinine and urine output
What are the major risk factors for AKI
Old age
proteinuria
CKD
HTN
DM
HTN
cardiac surgery
fluid overload
sepsis
What are some of the causes of AIN (acute interstitial nephritis)
Drugs (most)
infections
autoimmune disorders
List major complications of AKI
Development of CKD
Progression of CKD
CVD
ESRD
Based on the described urinary pattern, what kidney disease is suggested?
Renal tubular epithelial cells, transitional epithelial cells, granular casts, or waxy casts
Acute tubular necrosis (ATN)
