presentation of renal disease

Question 1

what are the usual presenting complaints of local renal disease?

Answer 1

loin/abdo pain, macroscopic haematuria, recurrent UTIs

Question 2

what systemic signs can you see in renal disease?

Answer 2

pyrexia, skin rash, heart murmurs, consolidation, ENT, retinopathy (DM & HBP), neuropathy, arterial bruits, rheumatoid

Question 3

what symptoms are related to loss of kidney function?

Answer 3

pallor, arrythmia, pericardial rub, raised JVP, lung creps, oedema, gout

Question 4

what is accelerated hypertension?

Answer 4

diastolic bp > 120mmHg
medical emergency
cam present with papilloedema and end-organ decompensation (encephalopathy, fits, cardiac failure, acute kidney injury)

Question 5

what does frothy urine indicate?

Answer 5

proteinuria

Question 6

what are the 3 classes of proteinuria?

Answer 6

Asymptomatic Low Grade (< 1 G/Day)
Heavy Proteinuria (1 - 3 G/Day)
Nephrotic Range (>3 G/Day)

Question 7

what is the definition of acute kidney injury?

Answer 7

Decline in GFR over hours / days / weeks

with or without oliguria (<400ml urine output/day)

in a patient with normal or impaired baseline renal function

Question 8

what is the triad of features of nephrotic syndrome due to glomerular disease?

Answer 8

• Proteinuria > 3 g/day (mostly albumin, also globulins)
• Hypoalbuminaemia
• Oedema (periorbital oedema specifically suggests nephrotic syndrome)

Question 9

what are the sign and symptoms of nephritic syndrome (glomerulonephritis)

Answer 9

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

Question 10

what part of the kidney to both nephrotic and nephritic disease affect?

Answer 10

glomerulus