Misc Flashcards
Glomerulonephritis dx?
Hypertension, hypoPROTEIN/ALB, hyperCHOL, hyperCOAG
Don’t bx in stage IV iris or if coagulopathy
Nephrotic syndrome dx?
Proteinuria, hypoALB, ascites/edema, hyperCHOL
Glomerulonephritis tx?
Tx hypertension, tx proteinuria, tx hypercoagulability (aspirin, clopidogral)
Nephrotic syndrome tx?
MYCOPHENOLATE #1!!! don’t use glucocorticoids alone
Alternatives—cyclosporin, chlorambucil, azathioprine, cyclophosphamide
Immunosuppressive—NOT in pancreatitis, BM suppression, DM, etc
What is azotemia?
Abnormal increase in NPN wastes in blood (UREA + CREAT)
What is uremia?
Clinical condition because of increase in urea
What are the 4 manifestations of uremic syndrome?
Azotemia
HypoALB
HyperCHOL
Metabolic acidosis
(Also hyperK, hypoCa, inc PTH)
What are the DIRECT methods of measuring GFR?
RENAL SCINTIGRAPHY—gold standard
Iohexal
Inulin
Creatinine clearance
What are INDIRECT methods for measuring GFR?
UREA
CREAT
Cystatin C
SDMA
Urea test + limitations
Synthesized in liver, excreted in kidneys
Limitations—passive reabsorption in tubules, not reliable estimate of GFR
False increases—eat alot of protein, bleeding into guts
CREAT test + limitations
Synthesized by breakdown of creat in muscle
Produced at constant rate, dependent on muscle mass, less influenced by diet
Better indication of GFR but relationship NOT linear
Limitations—azotemia doesn’t develop until GFR decreased to 25%
Cystatin C test + limitations
Small polypeptide protease inhibitor produced by all cells with a nucleus
Produced at constant rate in all tissues
Excretion not dependent on age, sex, or diet
SDMA test + limitations
Methylated form of AA arginine, excreted almost exclusively by kidneys
Correlated highly with GFR by inulin
See changes when 40% dec in GFR
What does renin do?
Increases BP
What hormones does the kidney make?
Renin, EPO, active vit D
