nephrology Flashcards
Prevention of kidney injury due to tumor lysis syndrome following chemotherapy
Allopurinol, Hydration, Rasburicase
When is dialysis required for patients with ATN
Fluid overload Metabolic acidosis Encephalopathy percarditis hyperkalemia
treatment of Rhabdomyolysis
Hydration
mannitol
Bicarbonate
Drug(s) that causes ototoxicity
Loop diuretics such as furosmide
Also caused by aminoglycoside antibiotics
Hepatorenal syndrome lab work shows
Very low urine sodium (20:1)
Treatment of hepatorenal syndrome
Midodrine
Octreotide
Albumin
Presentation of atheroembolic acute kidney injury
Blue/purplish skin lesions in the fingers and toes
livedo reticularis
ocular lesions
-occurs in a patient who undergoes coronary angioplasty and several days later develops renal failure
Lab tests for Atheroembolic disease
Eosinophilia
Low complement levels
Eosinophiluria
elevated ESR
Most accurate diagnostic test for atheroemboli
biopsy of on of the skin lesions
- usually shows cholesterol crystals
treatment of atheroemboli
No specific therapy
Presentation of AIN
Fever
Rash
Eosinophilia
arthralgia
What is different about urinalysis on NSAIDs causing AKI
NO EOSINOPHILS are seen in the urine
AIN: labs
Eosinophilia
Eosinophiluria
BUN:Cr <20:1
Una and FeNa: increased
AIN: best initial test and most accurate test
Best initial: UA - shows WBCs
Most accurate: Hansel and Wright stain - determines the type of WBC- eosinophils
AIN treatment
Resolves spontaneously with stopping the offending agent or controlling infection and autoimmune diseases
- if still no response: STEROIDS
- Sever disease: dialysis
Presentation of Papillary necrosis
Sudden onset of flank pain, fever and hematria in a patient taking NSAIDs with underlying diseases that affect kidney function:
Sickle cell disease
diabetes
urinary obstruction
Chronic pyelonephritis