Renal Disease Flashcards
What causes the dilatation of the urinary collecting system during pregnancy?
- Progesterone inducing Ureteral smooth muscle relaxation
- Enlarging uterus or iliac vessels compressing the ureters
Dilatation more pronounced on the right
Up to what measurement, can the pelvicaliceal diameter be normal in pregnancy?
2cm
What happens to renal plasma flow and glomerular filtration rate in pregnancy?
They both increase
Creatinine clearance rises by 50%
Results in a fall in the serum urea and creatinine levels
What happens to protein excretion in pregnancy?
Increases
Hence why the upper limit of normal in pregnancy is 30mg / mmol
What % of women develop some oedema in pregnancy?
80%
What % women have asymptomatic bacteruria in pregnancy?
Of these, how many will develop
A) Symptomatic UTI
B) Acute pyelonephritis
4-7%
A) 40%
B) 30%
What is the course of treatment for asymptomatic bacteruria in pregnancy?
3 days
What non-pharmacological measures may help prevent recurrent UTIs
- Increasing fluid intake
- Emptying the bladder following sexual intercourse
- Double voiding
- Front to back cleaning of perineum
What are risk factors for acute pyelonephritis?
Polycystic kidneys
Congenital abnormalities of the renal tract
Neuropathic bladder
Urinary tract calculi
What is the effect of pregnancy on CKD?
Possible accelerated decline in renal function
Escalating HTN
Worsening proteinuria
Flare / relapse of glomeurlonephritis
What is the effect of CKD on pregnancy?
HTN / PET FGR PTB Polyhydramnios (due to uraemia) Miscarriage Fetal death
What should women with CKD Stage 5 be advised?
Against conceiving
What is the pathogenesis of polyhydramnios in CKD?
High maternal urea
Osmotic load
Fetal polyuria
Polyhydramnios
What % women with reflux nephropathy develop PET?
25%
How is reflux nephropathy inherited?
AD