Overview of renal diseases

Question 1

How do we measure kidney function?

Answer 1

Blood tests - creatine, formulae
Urine output
Elimination of radioisotopes

Question 2

Renal syndromes

Answer 2

Asymptomatic proteinuria 
Nephrotic syndrome 
Haematuria 
Chronic Kidney Disease 
Acute kidney injury
Nephritic syndrome

Question 3

What is nephritic syndrome?

Answer 3

Symptoms associated with inflammation of the kidneys

Question 4

What is nephrotic syndrome?

Answer 4

Too much protein in the urine

Question 5

Acute Kidney Injury

Answer 5

Affects 20% emergency admissions
20-30% may be preventable
Mortality 25-40%

Question 6

Pre-renal causes

Answer 6

Hypovolemia - Haemorrhage, diarrhea/vomiting
The decrease in Perfusion- Septic shock, Cardiac failure
Drugs - Angiotensin-converting inhibitors, Non-steroid anti-inflammatory drugs

Question 7

Vascular disease

Answer 7

Hypertensive nephrosclerosis
Renal arteries stenosis
A theroemboli
thrombotic microangiopathy
vasculitis

Question 8

Tubulointerstitial disease

Answer 8

Acute tubular injury

Acute tubulointerstitial nephritis

Question 9

Principles in glomerular disease

Answer 9

Distinguish between 1 degree and 2-degree disease

Weather 1 degree or 2 degrees, limited response to injury (5 clinical syndromes)

Question 10

1 degree glomerular disease

Answer 10

Nephrotic syndrome 
Nephritic Syndrome 
Asymptomatic 
Urinary abnormalities 
Rapidly progressive GN
CKD

Question 11

Nephrotic syndrome

Answer 11

Heavy proteinuria
Hypoalbuminaemia
Oedema
Plus: Frothy urine, hypercoagulability, hypercholesterolemia
Causes: minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis

Question 12

Nephritic syndrome

Answer 12

Abrupt onset over 1-3 days
Haematuria
Proteinuria
Decreased GFR (raised creatinine, oedema, hypertension)
Classical cause: post-streptococcal GN

Question 13

Asymptomatic urinary abnormalities

Answer 13

Haematuria
Proteinuria
Multiple causes, but IgA nephropathy important