Oliguria/Proteinuria Flashcards
What are the vast majority of CKD cases caused by?
DM or HTN
What are the 3 simple tests to identify most CKD patients?
eGFR
Urine albumin:creatinine ratio or urine protein:creatinine ratio
UA
What sxs do most CKD patients have?
Very variable, most asymptomatic and only find from routine lab screening
What are the renal US findings for CKD?
Atrophic or small kidneys
Cortical thinning
Increased echogenecity
Elevated resistive indices
What are the indications for dialysis in CKD?
A: Severe acidosis
E: Electrolyte disturbance (usually hyperkalemia)
I: Ingestion (ethylene glycols, methanol)
O: Volume overload
U: uremia
What are some causes of prerenal AKI?
Hypotension
Hypovolemia
Reduced cardiac output
Systemic vasodilation (sepsis)
What are some causes of intrinsic AKI?
Tubular necrosis
Interstitial nephritis
Glomerulonephritis
What are some causes of postrenal AKI?
Bladder outled obstruction Ureteral obstruction Renal pelvis (papillary necrosis, nsaids, stones)
Labs to obtain on all patients with AKI?
UA with urine microscopy
Urine albumin:creatinine ratio or urine protein:creatinine ratio
Also usually get renal US
How do you treat AKI in prerenal patients?
IV fluid
How do you treat AKI in acute tubular necrosis patients?
Supportive care
How do you treat AKI in glomerulonephritis?
Could need immunosuppression or plasmapheresis
How do you treat AKI in acute interstitial nephritis?
Discontinuation of offending agend and/or steroids (controversial)
What is serum albumin is normal in setting of nephrotic range proteinuria?
Patient does not have true nephrotic syndrome but instead has nephrotic range proteinuria (possible secondary FSGS)
