• Archive for April, 2013

    Nephrotic/Nephritic Syndromes

    by  • 28/04/2013 • Renal • 0 Comments

    Proteinuria and nephrotic syndrome:  Normal protein in urine <150mg/day (normal physiological protein = ‘Tamm-Horsfall protein’). o Proteinuria = 300mg-4.5g urinary protein/day o Microalbuminaemia = 30-300mg urinary albumin /day  Increased protein may = GN, if Bence-Jones (free light chains) = MM, if microalbuminaemia = diabetic nephropathy.  Ix: o Assess renal function: serum...

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    Acid-Base Balance Disorders

    by  • 28/04/2013 • Renal • 0 Comments

    In all seriously ill pts – an ABG should be performed to rule out acid-base disturbances. Metabolic acidosis: pO2 <8kPa (sats <90%), pH <7.35, pCO2 <5kPa  Seen in diabetic ketoacidosis, lactic acidosis and renal failure.  Severe acidosis results in cardiac depression and death.  Body responds to acidosis with respiratory compensation. Increased...

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    Hyponatriemia/Hypernatriemia

    by  • 28/04/2013 • Renal • 0 Comments

    Abnormalities of serum sodium are closely linked to water balance (excess losses vs excess administration). Hyponatriemia:  Serum sodium <130mmol/L  p/c: asymptomatic, confusion, coma, convulsions.  Types of hyponatraemia: o Hypovolaemia (‘dry’): with Na deficit. Renal losses (=diuretics, Addison’s, salt-losing nephropathy). Extra-renal losses (=vomiting, diarrhoea, burns, sweating). o Normovolaemia: with no change in...

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    Hypokalaemia/Hyperkalaemia

    by  • 28/04/2013 • Renal • 0 Comments

    Hypokalaemia:  Serum potassium <3.5mmol/L  Mostly attributed by diuretic therapy (increased losses from urinary/GI tracts), poor intake (eating disorders), or a shift to the intracellular compartment (insulin use, or familial periodic paralysis). o GI losses = vomiting and diarrhoea, laxative abuse, villus adenoma of colon. o Renal losses = diuretics, mineralocorticoid excess (Conn’s...

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    Renal Physiology and Renal Function

    by  • 28/04/2013 • Renal • 0 Comments

    Renal physiology and renal function  1 x kidney = 1 x million nephrons  Each nephron: glomerulus located in cortex – filters into renal tubule and LoH (main site of water and electrolytes reabsorption). Urine drains to collecting duct. Further water reabsorption. Drains to renal pyramids.  Thick ascending limb of LoH attaches...

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