Presentation of renal disease

Question 1

What are the different presentations which suggest renal disease ?

Answer 1

• Asymptomatic
• Loin Pain / Urinary Symptoms
• Haematuria
• Proteinuria
• Hypertension – quite often as there key in regulating BP
• Acute Kidney Injury
• Chronic Kidney Disease
• Nephrotic Syndrome
• Nephritic Syndrome

Question 2

What are some of the conditions linked with causing renal disease ?

Answer 2

• Diabetes mellitus
• Connective tissue disorder
• Vascular disease

Question 3

What is the target BP for people with renal disease ?

Answer 3

130/80

Question 4

What is accelerated hypertension

Answer 4

diastolic BP > 120

Question 5

If a patient is presenting with renal problems and a rash what sort of conditions are you thinking ?

Answer 5

• A vasculitis
• Glomerulonephritis
• SLE

Question 6

What are some of the drugs which can potentially cause renal damage ?

Answer 6

• ACE-I, ARB, diuretics (thiazide, loop, potassium sparing)
• NSAIDS
• Antibiotics: gentamicin, trimethoprim, penicillins
• Proton pump inhibitors
• Radiology contrast
• Over the counter/herbal remedies

Question 7

What is the preferred way of measuring protein levels in the blood ?

Answer 7

Protein/creatinine ratio (PCR)

Or

Albumin/creatinine ratio (ACR)

Question 8

What is the classic sign seen on ECG caused by hyperkalaemia ?

Answer 8

Tall tented T-waves

Question 9

What are the 3 key signs which suggest nephrotic syndrome ?

Answer 9

• Proteinuria > 3 g/day (mostly albumin, also globulins)
• Hypoalbuminaemia
• Oedema

Also get hypercholesterolaemia

Question 10

What are the key signs of nephritic syndrome

Answer 10

• Haematuria
• Proteinuria
• Hypertension
• Low urine volume

Question 11

What is the main difference between nephrotic syndrome and nephritic syndrome ?

Answer 11

You loose lots of protein in nephrotic and you loose lots of blood in nephritic