presentation of diseases of the kidney and urinary tract Flashcards
What are the parts of the upper urinary tract
Kidneys and ureters
What is part of the lower urinary tract
Below the ureters e.g bladder and urethra
How do renal diseases present
Pain
Pyrexia
Haematuria
Proteinuria
Pyuria - sign of inflammation which is caused by infection
Mass on palpation
Renal failure
what is the definition of proteinuria
Excreting more than 150mg of protein in urine per day
How many types of haematuria are there and what are they
3:
Microscopic
Macroscopic
Dipstick haematuria
What is the definition of microscopic haematuria
More than 3 blood cells per high power field
What is oliguria
low urine output - <0.5mg/kg/hour
What is relative anuria
Urine output less than 100ml per day
What is absolute anuria
No urine output per day
What is polyuria
Excess urine output - >3L per day
What is nocturia
Waking up more than once in the night to micturate
What is nocturnal polyuria
The urine output in the night is greater than 1/3 of the total daily urine output
Why is micturition less common in the night
Because ADH production is increased which causes more reabsorption of water so less volume of urine to be excreted
What do we use to define acute kidney disease in terms of staging
R - risk
I - injury
F - failure
L - loss
E - end-stage kidney disease
Describe R in ‘RIFLE’ for AKI
R- risk - increase in serum creatinine x1.5 or decrease in GFR by 25%. or urine output less than 0.5ml/kg/hour for 6 hours (oliguria)
Describe I in ‘RIFLE’ for AKI
Injury - increase in serum creatinine x2 or decrease in GFR by 50% or oliguria 12 hours
Describe F in ‘RIFLE’ for AKI
Failure - increase in serum creatinine x3 - decrease in GFR by 75& or urine output less than 0.3mg/kg/hour or anuria for 12 hours
Describe L in ‘RIFLE’ for AKI
Loss - persistent acute renal failure or complete loss of kidney function for more than 4 weeks
Describe E in ‘RIFLE’ for AKI
End-stage kidney disease - complete loss of kidney function for more than 3 months
Presentation of chronic renal failure
Asymptomatic
Tired
anaemic
oedema
High Bp
Bone pain due to renal bone disease
Pruritus - unpleasant feeling making you want to scratch
Nausea/vomiting
Dyspnoea
Neuropathy
Coma
What do infections cause at the ureters
Ureteritis
What are Iatrogenic causes of ureteric diseases
Ureters are close to the GI so can be cut during surgery
What kind of cancers are in the urinary system
Transitional cell carcinoma (carcinoma of the uroepithelium)