Clinical presentation of renal failure and investigations Flashcards
How can renal dysfunction present
- Asymptomatic
- Proteinuria
- Nephritic syndrome
- Nephrotic syndrome
- Acute kidney injury (AKI)
- Acute tubular necrosis
- Microscopic haematuria
How do we assess a patients URINE
By using a urine dipstick
What does a urine dipstick examination show
Urine pH
Blood
Proteins
Glucose
Ketones
Bilirubin
Urobilinogen
In whom is a urine dipstick examination more frequently done
Pts at high risk of renal disease eg hypertensive or diabetics
Urine dipstick examination carried our annually
Other than renal function what else can urinary dipsticks assess
Screen for leukocytes and nitrites, suggestive of urinary tract infection
What might the detection of blood on a urine dipstick examination suffuse
Blood loss from the urinary tract secondary to urinary tract infection and bladder inflammation, renal stones or cancer etc
What might abnormal amounts of protein on a urine dipstick examination suggest
Damage and leakage at the glomerular filtration barrier with increased amounts of high molecular weight proteins overwhelming the tubular capacity for reabsorption
What does nephritic syndrome comprise of
- Oliguria
- Smokey or coca cola coloured urine due to haematuria
- Oedema
- Hypertension due to salt and water retention
- Acute renal dysfunction
What can the clinical presentation nephritic syndrome suggest
A variety of underlying renal pathologies causing disruption of the glomerular filtration barrier
What is nephritic syndrome due to usually
Immune mediate inflammation and glomerulonephritis
What can nephritic syndrome look like on a urine dipstick exam
Significant haematuria and proteinuria
What does nephrotic syndrome comprise of
- Significant proteinuria
- hypoalbuminaemia, which results in oedema
- hyperlipidaemia
What can the clinical presentation nephrotic syndrome suggest
Several underlying pathological processed with protein leakage at the glomerular filtration barrier
What can nephrotic syndrome look like on a urine dipstick exam
Exaggerated proteinuria
What was acute kidney injury previously referred to as
Acute renal failure