Nephrology Hypertension

Acute Kidney Injury: Complications associated with Acute Kidney Injury

Does this patient have complications associated with acute kidney injury? Introduction Acute kidney injury (AKI) is often associated with systemic complications including volume overload; electrolyte and acid-base disturbances, particularly hyponatremia, hyperkalemia and metabolic acidosis; nutritional and gastrointestinal disturbances; anemia and bleeding diatheses, and increased risk of infection. It is often difficult, however, to differentiate complications…

Acute Kidney Injury: Prevention of AKI

Does this patient have acute kidney injury (AKI)? Acute kidney injury (AKI), formerly acute renal failure, refers to an abrupt (within 48 hours) reduction in kidney function leading to azotemia. Traditional markers–blood urea nitrogen (BUN) and serum creatinine (SCr) remain the gold standard for the assessment of kidney function. The use of creatinine is complicated…

Kidney Stones

History, signs, and symptoms The prevalence of kidney stones in the United States has been increasing for at least the past 30 years and is currently about 5%. Most kidney stones (85-90%) are composed primarily of calcium oxalate with some containing calcium phosphate, and the majority of these are idiopathic; that is, not caused by…

Glomerular and Vascular Diseases: Sickle Cell Disease

Does this patient have sickle cell nephropathy? Renal complications observed in patients with sickle cell disease (SCD) and/or sickle cell trait. May range from mild tubular dysfunction to chronic kidney disease (CKD). Renal abnormalities would include: hematuriaContinue Reading renal papillary necrosis tubular dysfunction proteinuria nephrotic syndrome chronic kidney disease renal medullary carcinoma acute kidney injury…

Glomerular and Vascular Diseases: Systemic and renal vasculitis plus Membrane Disease

Does this patient have antineutrophil cytoplasmic antibody disease or antiglomerular basement membrane disease? Antineutrophil cytoplasmic antibody (ANCA) disease is associated with four clinical phenotypes: Granulomatosis with polyangiitis (GPA, formerly Wegener’s granulomatosis), microscopic polyangiits (MPA), eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg Strauss syndrome) and pauci-immune necrotizing and crescentic glomerulonephritis without clinical extra-renal manifestations of vasculitis…

Glomerular and Vascular Diseases: Membranous Nephropathy

Does this patient have membranous nephropathy? Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults and is found in 15 to 33% of kidney biopsies performed for heavy proteinuria. MN derives its name from its histological pattern on light microscopy: glomerular basement membrane (GBM) thickening with minimal or absence…

Glomerular and Vascular Diseases: Minimal Change Disease & Focal segmental Glomerulosclerosis

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Does this patient have minimal change disease and focal segmental glomerulosclerosis? Presentation Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) present with symptoms and signs of the nephrotic syndrome, characterized by edema, heavy proteinuria (greater than urine protein to creatinine ratio [UPCR] of 3), hypoalbuminemia, and hyperlipidemia. Patients may observe foamy or frothy urine.…

Diabetic Kidney Disease: Hypertension Management

Does this patient have diabetes-related hypertension? Presentation of hypertension in diabetic nephropathy A 58-year-old man presents with elevated blood pressure (BP) confirmed on two occasions by his primary care physician. At his first visit, his BP was 162/88 mmHg, and he was advised to lose weight, exercise, and limit sodium consumption. He currently feels well.…

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