Renal Vascular Problems Flashcards
what is RAS?
narrowing of renal arteries
causes of RAS
atherosclerosis
young females- fibromuscular dysplasia
what does RAS cause?
flow into the glomerulus is reduced and the macula densa incorrectly sense low BP causing the patient to develop hypertension
presentation of RAS
poor kidney function
vascular disease- claudication, hypertension, bruit
diagnosis of RAS
U&Es USS doppler for arteries CT angiogram (use MRI to avoid contrast use)
management of RAS
CCB amlodipine
statin
what drugs do you not give in RAS?
NSAIDs (reduce prostaglandins which are vasodilators)
ACEI (want angiotensin to constrict vessel)
what is loin pain haematuria syndrome?
periods of severe unilateral loin pain radiating to abdomen, thigh or groin
presentation of loin pain haematuria syndrome
loin pain that radiates
dysuria
vomiting
low grade fever
describe how jogger’s haematuria occurs
there is constriction of efferent arteriole and increased filtration pressure causes red cells to get through the membrane leading to hypoxic damage to nephrons
how long does jogger’s haematuria last?
should disappear within 7 days
weird causes of haematuria
blood thinners clotting disorders food (beetroot) myoglobulin (rhabdomyolysis, McArdle and Bywaters syndrome) drugs (doxyrubicine, senna, rifampicin) gynaecological toxins (lead and mercury)
signs of communication between bladder and bowel
pneumaturia
faecaluria
abdominal and loin pain
investigations for kidney trauma
CT and contrast
blunt kidney trauma management
angiography/ embolisation
surgery if persistent bleeding, expanding haematoma, etc.
