Renal Overview

Question 1

what happens if the kidneys are unable to excrete nitrogenous waste (urea)?

Answer 1

uraemia (pericarditis, encephalopathy, neuropathy, asterixis and gastritis)

Question 2

what happens if the kidneys cannot control fluid balance?

Answer 2

fluid retention and oedema

Question 3

what happens if the kidneys cannot control electrolyte balance?

Answer 3

hyperkalaemia

arrhythmias

Question 4

what happens if the kidneys cannot control acid-base balance?

Answer 4

metabolic acidosis and Kussmaul’s respiration

Question 5

what happens if the kidneys cannot control vitamin D metabolism and phosphate excretion?

Answer 5

renal bone disease

vascular calcification

Question 6

what happens if the kidneys cannot produce erythopoietin?

Answer 6

anaemia

Question 7

what happens if the kidneys cannot excrete drugs?

Answer 7

drug toxicity e.g. digoxin and gabapentin

Question 8

what happens if the kidneys loss barrier against proteins

Answer 8

proteinuria and nephrotic syndrome

Question 9

common presentation of glomerular injury/ disease?

Answer 9

proteinuria

Question 10

common presentation of interstitial disease?

Answer 10

raised creatinine/ reduced GFR with bland urine dip

Question 11

measuring proteinuria

Answer 11

reagent strips (screening)
ACR or PCR performed on 24 hour urine (ACR for low levels- diabetes)

Question 12

how to assess kidney biopsies

Answer 12

H&E staining= glomeruli
LM
IF= immune components e.g. Goodpasture’s IgG
EM