renal Flashcards
AKI:
- Refers to rapid drop in kidney function
- is diagnosed by measuring serum creatinine
- is most common in acutely unwell patients
Antibodies for AKI+haemoptysis patients? (Glomerulonephritis)
- Anti- GBM antibodies- Goodpasture Syndrome
- p-ANCA- Microscopic Polyangitis
- c- ANCA- Granulomatosis with Polyangitis
-Diagnosis: may require a renal biopsy
Triad of Symptoms in Haemolytic Uraemic Syndrome?
- AKI (Acute Kidney Injury)
- Thrombocytopenia (low platelets
- Microangiopathic Haemolytic Anaemia
- Is usually triggered with Shiga toxins (either E.coli or Shigella)
Symptoms of haemolytic uraemic syndrome?
- Confusion (from the uraemia)
- Bruising (from the low platelets)
- Abdominal pain
- Pallor (anaemia)
- Hypertension (Renal failure)
- NB: is a medical emergency, and requires hospital admission and supportive management.
- most patients fully recover.
Rhabdomyolysis:
- Causes muscle breakdown, the most dangerous breakdown product= Potassium (can result in Hyperkalaemia)
Managing anaemia in CKD?
1st: correct iron deficiency, then start Erythropoiesis-stimulating agents.
CKD management if urine albumin-to-creatinine ratio is more than 30?
Should be started on an ACE-inhibitor,
- is only bad in acute AKI
Medication that can be a cause of Acute Interstitial Nephritis?
- NSAIDS
common presentation in Renal Tubular Acidosis?
- Renal calculi
- Osteomalacia
what is a common complication of nephrotic syndrome?
there is an increased/high risk of VTE, therefore prophylactic LWMH is needed (due to loss of anti-thrombin III)
Complications of steroids (used for nephrotic syndrome)
- Obesity
- Growth retardation
- Papilloedema
what to do next? for patient more than 60 yrs presenting with unexplained non-visible haematuria + raised WCC?
Needs an urgent 2 wait week referral to an urologist; as need to rule out bladder cancer
NB: most common type of bladder malignancies= Urothelial carcinoma (transitional)
BPH Mx?
- Tamsulosin(1st line) + Finasteride (2nd line)
how should you manage Uraemia (confusion- encephalopathy or pericarditis)?
Dialysis
Investigation to do for an AKI of unknown cause?
Renal Ultrasound
Another drug that can cause Acute Interstitial Nephritis?
Aminoglycoside antibiotics, presents as white cell casts and E coli infection
Definitive diagnosis for Acute Interstitial Nephritis?
Renal Biopsy
Screening test for Polycystic Kidney Disease?
- Ultrasound (if this is inconclusive, then do CT abdomen/pelvis)
1st line investigation in suspected prostate cancer?
MRI (multiparametric)
- used to be Trans-rectal ultrasound biopsy (TRUS)
What anticoagulant is safe to use in AKI?
- Warfarin
- What condition is an indication for Haemodialysis in a patient with an AKI?
Pulmonary Oedema
