Renal diagnostics Flashcards
Pre-renal:
any process decreasing g renal perfusion
Renal:
Vascular, glomerular, tubulointerstitial
Post-renal
obstruction of urine flow
Glomerular Filtration Rate (GFR):
- most common assessment
- Decrease= renal disease
- slowly declines after 30-35 years old
GFR measurement modes:
serum creatinine, 24 hr urine, spot urine, estimation equations, radioisotopic clearance
Serum Creatinine:
- byproduct of the breakdown of creatine phosphate in muscle
- filtered out by kidneys
- easily/readily obtainable
Serum creatine can be inaccurate with…
high muscle mass, diet, medications
24 hr urine:
- exact 24 hr collection
- cumbersome and may overestimate GFR
Spot Urine:
- Marker of urinary excretion of albumin
- kidney should be relatively impermeable to albumin
- microalbuminuria
Microalbuminuria:
-good screening for early kidney disease, especially diabetic nephropathy
Indications for hemodialysis:
- symptomatic uremia
- hyperkalemia despite tx
- volume overload despite tx
- acidosis
- decreased CrCl or EGFR
- bleeding diathesis
initial renal imagining:
US
US looks for:
hydronephrosis, polycystic disease, masses/lesions, obstructive uropathy
what imagining do you do if us shows abnormality or is technically limited:
CT
renal stones imaging:
Non-contrast CT
