Renal - Causes Of Renal Disease And Presentation Of Renal Failure

Question 1

Renal injury: pre-renal causes

Answer 1

• Shock

- renal vascular: renal artery stenosis, toxins (NSAIDs, ACEi, thrombosis, hepatorenal syndrome)

Question 2

Renal injury: renal causes

Answer 2

• Glomerulonephritis
• ATN
• interstitial disease

Question 3

Renal injury: post-renal causes

Answer 3

-Diseases of renal papillae, pelvis, ureters, bladder or urethra
-SNIPPIN:
Stone
Neoplasm
Inflammation: stricture
Prostatic hypertrophy
Posterior urethral valves
Infection: TB/schisto
Neurological

Question 4

Renal failure: name 6 main biochemical presentations

Answer 4

• Uraemia
• Protein loss and Na+ retention
• Acidosis
• Hyperkalaemia
• Anaemia
• Vitamin D deficiency

Question 5

Renal failure- signs and symptoms of uraemia

Answer 5

• eGFR must be <15ml/min
• Symptoms: lethargy, confusion, restless legs, pruritus
• Signs: pale, fits, come, pericardial/pleural rub

Question 6

Renal failure- signs and symptoms of protein loss and Na+ retention

Answer 6

• Symptoms: poly/olig/anuria, polydipsia, SOB

- Signs: oedema, raised JVP, HTN

Question 7

Renal failure- signs and symptoms of acidosis

Answer 7

• Symptoms: SOB/confusion

- Signs: Kussmaul respiration

Question 8

Renal failure- signs and symptoms of hyperkalaemia

Answer 8

• symptoms: palpitations, chest pain, weakness
• signs: peaked T waves, flattened P waves, raised PR interval, widened QRS, eventually progressing to sine-wave pattern (precursor for VF)

Question 9

Renal failure- signs and symptoms of anaemia

Answer 9

• Symptoms: breathlessness, lethargy, fainting, tinnitus

- Signs: pallor, tachy, flow murmurs

Question 10

Renal failure- signs and symptoms of vitamin D deficiency

Answer 10

• Symptoms: bone pain or pathological fractures

- Signs: osteomalacia