Renal Flashcards
Name some examples of nephrotoxic drugs
- ACE inhibitors,
- NSAIDs,
- Diuretics,
- Lithium
- Digoxin,
- Aminoglycosides,
- Metformin,
- Iodinated contrast media,
- Opioids
What are some causes of glomerulonephritis
Infections (streptococcus A, endocarditis, HIV)
Systemic inflammatory disease,
Drugs (NSAIDs, anabolic steroids)
What are the signs and symptoms of glomerulonephritis
- Haematuria,
- Proteinuria,
- Oedema,
- Hypertension,
- Joint pain,
- Rash,
- Fever,
- Weigh loss
What are some investigations and managements for glomerulonephritis
- Urinalysis,
- Urine microscopy,
- U+Es, FBC, CRP, ESR,
- Metabolic and lipid profile,
- Renal tract ultrasound,
- Renal Biopsy which is a definitive diagnosis
Management - antibiotics, ACEi, Corticosteroids, diuretics, immunosuppressants, plasmapheresis.
What are some causes of proteinuria
Diabetes, amyloidosis, UTI, pre-eclampsia
What are some vascular diseases which can impact the kidneys
- Hypertension,
- Vasculitis,
- Thrombotic thrombocytopenia purpura,
- Haemolytic uraemic syndrome
Describe features of nephritic syndrome
- Likely to present with haematuria, non-nephrotic range proteinuria and hypertension.
- Causes include post-infectious, vascular and systemic lupus erythematosus
Describe features of nephrotic syndrome
- Marked proteinuria, oedema, hypalbuminaemia (due to damaged glomerulus which causes massive loss of proteins in the urine), hyperlipidaemia (liver compensation for low albumin) and lipiduria.
Management - high dose steroids
What are symptoms of UTIs
- Urinary frequency,
- Dysuria,
- Urgency,
- Foul-smelling urine,
- Suprapubic pain
What are the UTI investigations?
- Urinalysis (leukocytes and nitrites)
- In children, men and pregnant women a mid-stream urine sample is needed for microbiology
What is the first line treatment for UTIs?
Nitrofurantoin or trimethoprim
What are the symptoms and treatment of pyelonephritis
Symptoms - patients will be febrile, vomiting and have flank pain.
Treatment - IV broad spectrum antibiotics (ciprofloxacin or co-amoxiclav)
What is pure nephrotic syndrome?
Minimal change disease
What is nephrotic syndrome with hematuria
Membranous glomerulonephritis
What is nephritic syndrome with nephrotic range proteinuria
Membrano-proliferative glomerulonephritis
