Renal Flashcards
Emergency treatment of hyperkalaemia
IV calcium chloride/gluconate (10ml) to stabilise myocardium
IV glucose and insulin (10% dextrose 200ml, 10U)
salbutamol 2.5mg neb
haemodialysis/filtration
indications for urgent dialysis
Uraemic encephalopathy
Hyperkalaemia resistant to medical treatment
uncontrolled metabolic acidosis
Pulmonary oedema with oliguria
signs pointing towards chronic renal failure
low haemoglobin
low serum calcium
elevated serum phosphate
causes of widespread airspace opacities on CXR
non-cardiogenic pulmonary oedema
pulmonary haemorrhage
aspiration
pcp
how does Goodpasture’s present
lung and renal tract involvement in young women
haemoptysis haematuria airspace opacities (likely haemorrhagic) hepatosplenomegaly hypertension oedema
signs of renal vasculitis
sinusitis epistaxis unilateral deafness mononeuritis haemoptysis skin rash
signs/symptoms of CKD
impotence pruritis weight loss hypertension pleural effusion bone pain (renal osteodystrophy)
why wouldn’t you do contrast-enhanced CT or IVU in person with CKD
contrasts are nephrotoxic
renal US findings in prostatic hypertrophy
hydronephrotic and small kidneys
cortical thinning
distended bladder and thickened wall
most common cause of nephrotic syndrome in middle aged men
membranous glomerulonephritis
triad of nephrotic syndrome
oedema
hypoalbuminaemia (<30g/L)
urinary protein loss >3g/24h
yearly renal screen for diabetics
urine albumin:creatinine ratio
NB: also retinopathy, foot assessment, U&E, HBa1C, weight and smoking assessment
Blood pressure targets for diabetics with hypertension
130/80
first line treatment for hypertensives + albuminuria
ACEi
ARB if not tolerated
when do you check U&Es again after starting ACEi if worried about RAS
10-14d after
ensure no more than 20% rise in serum creatinine
if >20% stop drug and image arteries
if hyperkalaemia occurs, stop or reduce dose
