Renal Flashcards
Acute Interstitial Nephritis features
fever, rash, arthralgia
eosinophilia
mild renal impairment
hypertension
white cell casts, sterile pyuria
Acute Interstitial Nephritis Causes
drugs: (the most common cause, particularly antibiotics)
penicillin
rifampicin
NSAIDs
allopurinol
furosemide
systemic disease: SLE, sarcoidosis, and Sjogren’s syndrome
infection: Hanta virus , staphylococci
Lithium in AKI
stop due to increased risk of toxicity
AKI definition
↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours
peritonitis secondary to peritoneal dialysis;
most common cause
staph epidermis
peritonitis secondary to peritoneal dialysis; treatment
vancomycin (or teicoplanin) + ceftazidime added to dialysis fluid
OR
vancomycin added to dialysis fluid + ciprofloxacin by mouth
feature suggestive CKD over AKI
hypocalcaemia
ADPKD Tx to slow progression
Tolvaptan
Dialysis disequilibrium syndrome
rare complication of harm-dialysis
It is caused by cerebral oedema, but the exact mechanism is unclear.
ADPKD features
hypertension
recurrent UTIs
flank pain
haematuria
palpable kidneys
renal impairment
renal stones
ADPKD extra renal features
liver cysts (70% - the commonest extra-renal manifestation): may cause hepatomegaly
berry aneurysms (8%): rupture can cause subarachnoid haemorrhage
cardiovascular system: mitral valve prolapse, mitral/tricuspid incompetence, aortic root dilation, aortic dissection
cysts in other organs: pancreas, spleen; very rarely: thyroid, oesophagus, ovary
diabetes insipidus: plasma/urine osmolality
high plasma osmolality, low urine osmolality
why is nephrotic syndrome associated with a hypercoagulable state
due to loss of antithrombin III via the kidneys
ADPKD Ix
Abdominal USS
Urine dip AKI
Pre-renal- n/a
intrinsic renal (tubules/glomerulus) - protein (maybe blood)
post-renal- blood
