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Renal > Presentation of kidney disease > Flashcards

Presentation of kidney disease Flashcards

1
Q

Give 8 categories of symptoms

A 
Asymptomatic
Loin pain/urinary symptoms
Haematuria
Proteinuria
Hypertension
AKD
CKD
Nephrotic syndrome
Nephritic syndrome
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2
Q

What are some of the main functions of the kidneys?

A 
Excretion of urea
Fluid balance
Electrolyte balance
Acid-Base balance
VD met
EPO production
Drug excretion
Barrier to protein loss
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3
Q

What symptoms may be seen with a loss of the kidneys’ ability to clear urine?

A 
Uraemia: 
pericarditis
encephalopathy
neuropathy
gastritis
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4
Q

What symptoms may be seen with a loss of the kidneys’ ability to fluid balance?

A

Oedema

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5
Q

What symptoms may be seen with a loss of the kidneys’ ability to regulate electrolytes?

A

Hyperkalemia

Arrhythmias

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6
Q

What symptoms may be seen with a loss of the kidneys’ ability to acid-base balance?

A

Metabolic acidosis

Deep laboured breathing

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7
Q

What symptoms may be seen with a loss of the kidneys’ ability to met VD?

A

Renal bone disease

Vascular calcification

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8
Q

What symptoms may be seen with a loss of the kidneys’ ability to produce EPO?

A

Anaemia

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9
Q

What symptoms may be seen with a loss of the kidneys’ ability to excrete drugs?

A

Drug toxicity

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10
Q

What symptoms may be seen with a loss of the kidneys’ ability to retain proteins?

A

Proteinuria

Nephrotic syndrome

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11
Q

How does asymptomatic kidney disease tend to present/be detected?

A

Raised BP
Incidental finding on abdo imaging
Dipstick test

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12
Q

What are some systemic symptoms of renal disease?

A

DM, connective tissue disease, vascular disease

Uraemic, fluid retention, anaemia, bone problems

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13
Q

What things are important to ask about in the systemic enquiry if suspecting renal disease?

A 
appetite & weight loss
nausea & vomiting
dyspepsia
dyspnoea
urinary symptoms
	e.g. frequency, urgency, hesitancy, polyuria & nocturia
joint pains & arthralgia
skin rashes
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14
Q

What drugs are very bad for the kidneys?

A

NSAIDS

Gent

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15
Q

What are some systemic signs of kidney disease?

A

pyrexia, skin rash, heart murmurs, consolidation, ENT, retinopathy (DM & HBP), neuropathy, arterial bruits, rheumatoid, pallor, arrythmia, pericardial rub, raised JVP, lung creps, oedema, gout

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16
Q

When is hypertension a medical emergency?

A

Accelerated hypertension

17
Q

What is accelerated hypertension?

A

Diastolic BP>120mmHg with papilloedema and/or end organ decompensation (cardiac arrest etc)

18
Q

What does specific gravity of urine measure?

A

Urine conc

19
Q

What is the standard way of measuring urine protein conc?

A

24h urine collection

20
Q

What is a normal protein reading for 24h urine collection?

A

<150mg/24h

21
Q

How is urine protein used?

A

As protein/creatinine ratio

22
Q

What is a normal protein/creatinine ratio?

A

0.5G/24h

23
Q

What are the three categories of protein/creatinine ratio?

A 
Asymptomatic- <1G/24h
Heavy Proteinuria (1 - 3 G/Day)
Nephrotic Range (>3 G/Day)
24
Q

What forms urinary casts?

A

Protein in urine

25
Q

What are the 5 stages of CKD?

A

Kidney damage with normal or increased GFR- >90
Kidney damage with mild decreased GFR- 60-89
Moderate decreased GFR- 30-59
Severe decreased GFR- 15-29
Kidney failure- <15

26
Q

What two paths can CKD take?

A

Stable or progressive

27
Q

What defines AKD?

A

Decline in GFR over hours / days / weeks from baseline (CKD sufferers can get AKD)

28
Q

What is nephrOtic syndrome?

A

Proteinuria >3 g/day (mostly albumin, also globulins)
Hypoalbuminaemia
Oedema
(Hypercholesterolaemia)

29
Q

What is nephrItic syndrome?

A 
Acute Kidney Injury
Oliguria
Oedema/ Fluid retention
Hypertension
Active urinary sediment
- RBC’s; Granular Casts, proteinuria

Renal (13 decks)

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