RENAL

 Nephrotic syndrome (proteinuria, albunemuria, frothy urine, edema)

 MINImal change disease
 Kids
 Membranous nephropathy
 MMM bran
 Men >40
 Malaria
 Meds (PCN)
 Focal Segmental Glomerulosclerosis
 Fornication = HIV
 Shooting up = heroin
 Grand BP = high BP
 Common in african americans
 Nephritic syndrome/glomerulonephritis
 IgA Nephropathy/beurgers dz
 Most common cause of glomerulonephritis
 IGA
 Infects guys always (not always but usually)
 Infects gastric & alveoli (occurs after URI or GI infxn)
 Prerenal
 Hypovolemia most common cause
 NSAIDs: Shrinking (vasoconstriction) Afferent 
 ACE-i: Expanding Efferent
 Diagnose: BUN/Cr >20:1
 Post renal
 Most common is obstruction
 Diagnosis is US to look for obstruction
 Tx cause
 Intrarenal
 Acute interstitial nephritis
 Most commonly caused by drugs!!
 Esp NSAIDs
 Always Involving Nsaids
 Diagnosis: WBC cast
 Tx: remove causative agent
 Acute tubular necrosis (ATN)
 Most common type of kidney injury
 Caused by ischemia or nephrotoxic agents (contrast, aminoglycosides)
 GRANULAR MUDDY BROWN CAST in UA
 Tx by removing offending agent & IV fluid
 BUN/Cr 10-15:1
 End stage renal disease: Waxy Cast
 Horsehoe Kidney assoc w turner syndrome
 Looks like U for tUrner
 U shape causes stasis of urine which incr risk of UTI & stones
 Diagnosis: CT urography
 Tx: tx sxs
 Polycystic kidney disease
 Autosomal dominant disorder
 Cysts in kidney & other organs, usually liver
 Sxs: abd & flank pain
 Incr risk of cerebral “berry” aneurysm
 If CKD is <15 GFR (Stage 5), then get dialysis
 MCC is Diabetes, 2nd is HTN
 WILMs tumor
 Kids
 Aniridia, doesnt cross midline, retarded, hypospadia, cryptorchidism
 Diagnostic: US
 Tx: nephrectomy
 Renal Cell carcinoma
 Tumor of proximal convoluted renal tubule cells (this area has high metabolic
rate making it prone to dysplasia)
 RF: smoking, htn, obesity, dialysis, men
 Sxs: hematuria, flank/abd pain/mass, left sided varicocele
 This tumor can produce parathyroid hormone related protein (PTHrP) which
mimics parathyroid hormone which causes hypercalcemia
 Diagnostic: ct
 Tx: radical nephrectomy
 Hyperkalemia
 Caused by:
 Cellular lysis (burn, rhabdo)
 Aldosterone decr (hypoaldosteronism, adrenal
insufficiency)
 Alodsterone is corticosteroid hormone that
stimulates kidney to absorb sodium
 Renal failure MCC
 Drugs (ACE/ARBs, k sparing diuretics like spironolactone)
 Sxs: muscle weakness, flaccid paralysis, cardiac arrhythmia,
abdominal distention, diarrhea
 EKG: peak T waves
 Tx: calcium gluconate 1st, then:
 Beta 2 agonist, insulin, glucose, kayexalate
 Hypokalemia
 Caused by:
 GI loss (diarrhea, vomiting, diuretics)
 Meds (insulin, etc)
 Hypomagnesemia (low mg opens mg dependent K channels into
urine)
 Sxs: muscle weakness, decr DTR, palpitations
 EKG: peaked U waves (anything extra after t wave)
 Tx: PO K+
 IV is only in severe