Renal

Question 1

5 absolute contraindications to renal transplant

Answer 1

1. Malignant disease (requires 2 years of remission after treatment before transplant is considered)
2. Severe IHD
3. Active vasculitis or anti-GBM disease
4. Occlusive aorto-iliac disease
5. Sepsis

Question 2

Criteria of nephrotic syndrome and its causes

Answer 2

1. Proteinuria >3.5g/24hrs
2. Hypoalbuminaemia <30g/L
3. Oedema
4. Hyperlipidaemia

Primary Causes

1. Idiopathic membranous glomerulonephropathy
2. FSGS
3. MPGN
4. Minimal change disease

Secondary causes
Systemic - SLE, DM, secondary membranous nephropathy (due to cancer), amyloid, MM

Infection - HBV, HIV, IE

Drugs - NSAIDs

Question 3

Compare and contrast PD and HD

Answer 3

PD

Advantages

1. Safe from CV point of view
2. Greater freedom of diet and fluid intake
3. Preferable for diabetics
4. Residual kidney function maintained - more stable in between dialysis sessions

Disadvantage

1. Peritonitis, exit site infection
2. Protein loss
3. Does not control uraemia in hypercatabolic patients
4. Hyperglycaemia

HD

Advantage

1. Large volumes can be ultra filtrated
2. No protein loss

Disadvantage

1. Circulatory access issues
2. Heparin may lead to increased bleeding
3. Increased CV instability
4. Dietary compliance still needed

Question 4

Target aim in anaemia due to renal failure

Answer 4

Between 110-125
EPO treatment is effective
Use IV iron replacement to keep ferritin >200 and transferrin saturation >24%

Question 5

Target blood pressure in CKD

Answer 5

120/75 mmHg

Question 6

5 types of renal osteodystrophy

Answer 6

1. Hyperparathyroid bone disease
2. Osteoporosis with decreased BMD
3. Osteomalacia
4. Osteosclerosis
5. Adynamic bone disease