Nephrology Flashcards
Causes (risk factors?) of CKD
1) DM
2) HPT
3) Glomerular disease (glomerulonephritis, hep B, hep C, SLE)
4) Autosomal dominant PCKD
5) Tubulo-interstitial nephropathy
6) developing countries: HIV, drugs, analgesic abuse, herbal, pollution
7) family history kidney disease
8) ageing
9) previous AKI
10) obesity
AKI: causes for small kidney on ultrasound
CKD
Renal artery stenosis
Hypertension
Renal agenesis
AKI: causes for large kidney on ultrasound
DM
Fabreys disease
Hydronephrosis/post renal obstruction
Amyloid
Sarcoid
Multiple myeloma
Indications for renal biopsy
Uncertain diagnosis
Renal azotemia (increased Cr and urea) or ATN unlikely
Oliguria persists more 2-4days
Anuria
Less than 100ml urine in 24hrs
Consequences of AKI or CKD
MAD HUNGER
Metabolic
Acidosis
Dyslipidaemia
High potassium
Uraemia
Na/H2O retention
Growth retardation
Erythropoietin decreased
Renal osteodystrophy
Acute dialysis indications
Acidosis: refractory, (<7,1), Anuria
Electrolytes: persistent severe hyperkalaemia, hypercalcaemia
Intoxication: ASA, lithium, methanol
Overload: refractory fluid overload: pulmonary oedema, peripheral oedema
Uraemic symptoms
Define nephrotic syndrome
A clinical syndrome affecting the kidneys, characterised by significant proteinurea, hypercholesterolaemia and peripheral oedema.
Features of nephritic syndrome
Proteinuria (<3.5g/24hrs)
Haemaguria
Azotaemia
Rbc casts in urine
Oliguria
Hypertension
Presentation of nephrotic syndrome
Hypoalbuminaemia (<25g/L), hypercoaguable
Edema
Lipids increased (TG)
Proteinuria (>3.5g/24hrs)
Define Polyuria
Urine volume of more than 3L/24hrs
Define AKI
An abrupt decrease in kidney function resulting in the renter ion of urea and other waste products and the dysregulation of fluid and electrolytes, also associated with decreased urine output
Define acute tubular necrosis
A syndrome characterised by structural and functional damage of the renal tubules and a functional decrease in glomerular function. The 3 major causes are ischaemia, sepsis and nephrotoxic drugs.
