Presentation of Renal Disease

Question 1

what different problems can renal disease present with

Answer 1

loin pain/urinary symptoms, haematuria, proteinuria, hypertension, acute/chronic kidney injury, nephrotic syndrome or nephritic syndrome

Question 2

can people with renal disease be asymptomatic

Answer 2

yes

Question 3

what tests can be done for people who are asymptomatic to check for renal disease signs

Answer 3

dipstick, eGFR, raised BP, abdo imaging, screening due to FH

Question 4

what can be tested/found using dipstick

Answer 4

haematuria or proteinuria

Question 5

what symptoms should be looked for in systemic enquiry for renal disease

Answer 5

appetite/weight loss, nausea/vomiting, dyspepsia, dyspnoea, urinary symptoms, arthralgia, skin rashes

Question 6

what are some examples of important aspects of a PMH for renal disease

Answer 6

kidney disease, diabetes, vascular disease, rheumatological disease

Question 7

what FH is important in renal disease

Answer 7

renal disease, hypertension

Question 8

what social history is relevant in renal disease presentation

Answer 8

smoking, alcohol, occupation carers

Question 9

what signs are related to loss of kidney function

Answer 9

pallor, arrhythmia, raised JVP, lung creps, oedema, gout

Question 10

what effect on BP is very common in renal failure

Answer 10

hypertension

Question 11

what clinical signs are associated with accelerated hypertension, sometimes seen in renal failure

Answer 11

BP >120 diastolic, papilloedema, end-organ decompensation

medical emergency

Question 12

what skin changes can be associated with renal disease

Answer 12

gout tophus, splinter haemorrhages, vasculitic skin rash, HSP, malar rash

Question 13

what level of proteinuria is defined as nephrotic

Answer 13

> 3 g/day

Question 14

what is the definition of stage 1 and 2 chronic kidney disease(CKD)

Answer 14

1 = kidney damage with GFR >/= 90
2 = kidney damage with GFR 60-89

Question 15

what is the definition of stage 3 and 4 CKD

Answer 15

3 = moderately low GFR 30-59
4 = severely low GFR 15-29

Question 16

what is the definition of stage 5 CKD

Answer 16

5 = kidney failure GFR <15

Question 17

describe acute kidney injury

Answer 17

decline of GFR over hours/days/weeks, with or without oliguria, in a person with normal or impaired baseline renal function

Question 18

what is the triad of clinical signs seen in nephrOtic syndrome

Answer 18

proteinuria > 3g/day, hypoalbuminaemia, oedema

due to glomerular disease

Question 19

describe the renal function often seen in nephrOtic syndrome

Answer 19

often normal

Question 20

what are the signs and symptoms associated with nephritic syndrome(glomerulonephritis)

Answer 20

active urinary sediment, hypertension, oedema/fluid retention, acute kidney injury, oliguria

Question 21

what is meant by active urinary sediment

Answer 21

RBCs, proteinuria etc.