Presentations of kidney and urinary tract disease Flashcards
Olgiuria definition
Urine output <0.5ml/kg/hr
Nocturnal polyuria
Nocturnal urine output >1/3 of urine output in 24hrs
Nocturia definition
Waking up at night > or equal 1 occasion to micturate/void
Polyuria definition
urine output >3l/24hrs
Anuria definition
No urine output
What is the 1st stage of acute kidney injury?
Risk- increase serum creatinine by 1.5x or decreased GFR by 35% or urine outflow <0.5ml/kg/6hrs
What is the second stage of AKI?
Injury- increase in serum creatinine level 2X or decrease in GFR by 50% or UO <0.5ml/kg/for 12hrs.
What is the 3rd stage of AKI?
Faliure-increase in serum creatinine level 3x or decrease in GFR by 75% or UO <0.3ml/kg/24hrs or anuria for 12hrs
What is 4th stage of AKI?
Loss- persistent acute renal failure or complete loss of kidney function> 4weeks.
What is the final (5th) stage of AKI?
End-stage kidney disease-complete loss of kidney function >3months.
What are the functions of the kidney?
Body fluid homeostasis Electrolyte homeostasis Acid-base homeostasis Regulation of vascular tone Excretion of waste or toxic substances Endocrine functions- vit D metabolism, renin
What are some specific lower urinary tract symptoms (LUTS)?
Storage problem symptoms: frequency, nocturia, urge incontinence
Voiding problem symptoms: poor flow, intermittency, terminal dribble
incontinence symptoms: stress, urge, overflow, dribbling.
What is the risk of a patient having bladder cancer if they present with visible haematuria?
25-30%
Define acute urinary retention
Painful inability to void with a palpable and percussible bladder.
Most commonly caused by benign prostatic obstruction.
Bladder volume >800ml
Define chronic urinary retention
Painless, palpable and percussible bladder after voiding.
This patient will have a large residual volume of urine in the bladder, this is usually due to detrusor underactivity.
Only the patients with high residuals and therefore high pressure need treatment- they should be immediatley catheterised.
What is stangury?
Severe pain and strong desire to urinate (a particular symptom of cystitis) which is caused by blockage or irritation at the base of the bladder. Will feel like bladder has not been empitied even though the patient just voided.
What are features of acute pyelonephritis?
Pyrexia, poor localisation of pain, loin tenderness, dehydration
Turbid (cloudy or frothy) urine
