Renal Flashcards
What does the urorectal septum connect to the umbilicus via, and what does it become in adult life
Urachus, becomes median umbilical ligament
What is minimal change disease?
immune-mediated damage to the glomerular basement membrane, resulting in leakage of intermediate-sized protein, such as albumin, into the urine
what causes minimal change disease?
IDIOPATHIC
drugs e.g. NSAIDs, rifampicin
Hodgkins Lymphoma
Glandular Fever
Features of minimal change disease
nephrotic syndome
management of minimal change disease
steroids
if not responsive cyclophosphamide
prognosis following minimal change disease
1/3 no relapse
1/3 infrequent relapse
1/3 frequent relapse
nephrotic syndrome
proteinuria
hypoalbuminaemia
oedema
nephritic syndrome
haematuria
hypertension
causes of nephritic syndrome
rapidly progressive nephritis - Goodpasture’s or ANCA + vasculitis
IgA Nephropathy
causes of mixed nephritic/nephrotic presentation
diffuse proliferative glomerulonephritis - post-strep, SLE
membranoproliferative glomerulonephritis
Causes of nephrotic syndrome
minimal change disease
membranous glomerulonephritis
focal segmental glomerulosclerosis
urinary osmolality and sodium in pre-renal AKI
urinary osmolality high
sodium low
urinary osmolality and sodium in renal AKI
urinary osmolality low
sodium high
drugs to stop in AKI
5 which worsen it, 3 which may reach toxic levels
- NSAIDs
- Aminoglycosides
- ACE inhibitors
- Angiotensin II receptor antagonists
- Diuretics
- Metformin
- Lithium
- Digoxin
alternative to spironolactone if causing gynecomastia
Eplerenone
