Renal Flashcards
Which presents with nephritic syndrome - IgA nephropathy or membranous glomerulonephritis
Ig A
Note: membranous GN more likely to present with nephrotic syndrome
In a pt with ESRD and anaemia on oral Fe supplementation with transferin sats > 20% and ferritin > 100 what is the next step in mgmt ?
EPO
Not IV Fe replacement
Typical presentation of acute interstitial nephritis
Typical clinical features include:
Renal failure with fever
Arthralgia
Eosinophilia
Eosinophiluria
Blood pressure in Liddle syndrome and Bartter syndrome
Liddle - elevated BP
Bartter - normal BP
Renin and aldosterone in Liddle syndrome?
Low
Note: higher in Bartter and Gitelman
Lab value to distinguish Gitelman from Bartter?
Mg - v low in Gitelman and normal/mild dec in Bartter
What is the main clinical feature that differentiates RTA type 1 (distal) from type 2 (proximal)
Nephrolithiasis is present in type 1
Note: type 1 is due to failure of acidification of urine at the collecting ducts and hence urine pH is persistently alkaline and favours the precipitation of Ca phos leading to stone formation
type 2 is due to a failure of bicarb reabs but urine can still be acidified by the collecting ducts
Complement levels are low in IgA nephropathy T/F
F - they are normal
Contrast to post strep GN where C3 is low and C4 can be slightly low too
Type 1 RTA is associated with what drugs?
Li
Amphotericin B
Cisplatin
Toluene
Which RTA is associated with Fanconi syndrome?
Type 2
Which RTA is assoc with SLE or sickle cell disease?
Type 4
Which RTA is assoc with RA and Sjogren’s?
Type 1
Which RTA has hyperK?
Type 4
Note: type 2 and 1 have hypoK
Lab abnormalities in Bartter syndrome?
Metabolic hypokalaemic alkalosis
Hypercalciuria
Increased renin and aldosterone
Note: normal Mg, normal BP
Patients with Bartter syndrome are hypertensive T/F
F - normotensive
Membranous GN is assoc with
Malignancy
Medications: penicillamine, GOLD, captopril, and heavy metals (mercury and cadmium)
Autoimmune disease: SLE, thyroid, Rheumatoid arthritis
Hepatitis B
Odd infections - like syphilis, leprosy, HIV, schistosomiasis, malaria
Sickle cell disease
Note: Elderly patients, male more than female. Immune complex deposition with IgG and C3. Nephrotic syndrome is the main presentation
Patients with chronic kidney disease who have proteinuria equivalent to ACR ≥70 mg/mmol should have their blood pressure controlled to the target range ____
120-129/<80 mmHg
Note: same target range should be used in patients with diabetes.
5 yr mortality of renal artery stenosis
80%
Patients with APKD should undergo routine screening for cerebral aneurysms T/F
F
Note: only high risk patients should undergo screening. Indications for screening:
-previous rupture of aneurysm
-concerning neurological symptoms (for example, severe headache)
-positive family history of haemorrhagic stroke or aneurysm.
Finding on renal biopsy in post strep GN?
Wire loop lesion
Note: A wire-loop lesion is a capillary loop with immune complex deposition circumferential around the loop. They may also be seen in lupus nephritis.
Which is associated with ADPKD AS or MVP?
MVP present in 20% pts with ADPKD
Note: AS is not associated in ADPKD
