Nephrology

AKI

CRF

Renal replacement therapy

Nephrotic syndrome

Nephritic

Renal vascular disease

R

polycystic kidney dls

Hereditary dis kidney

 aue

foiurell.es
t
I

NS N 0.8 1.2mg d
GM I 1.5mi kg hr
t
E in Aki fed to
70.3mg dl
20.5melkglhr for
48hr5 6hr5
Con I
a su er 7,15times red fluid volume
baseline t in

prior 7 days

I
dinic_wvesld0e
I f.x U Frost
U pericarditis v Gastro
Uremic
skin
encephalopathy chest pain constipation
t
t pruritis
pericardial Diaphragm
seizures
rub Hiccups
Altered sensorium
Coma

flapping Tremors

DID
Hepatic encephalopathy

CO2 Narcosis

anuidoverlex
H

duoutt
t.si I
U
Seri orbital pleural P'edema oliguria
edema effusion 4400mi
AG

pericardial Dyspny Amphoteri

Earliest I
effusion B
Round El Anuria
Hemoglobin
Ascites Toome
 I
face Red

Myoglobinuria
Dark Brown

Etiologyotad
056 Abdomen

I
sve renal Intrinsic Post Renal

Kidney out side

tied venal kidney
perfusion t t

Bladder Bplt Renal vein

Uretevic
Mcc in thrombosis
4 Bladder stones malignancy
I

am
red Iv
Eo Renal
volime vasoconstriction
CHF NSAIDS
Hemorrhage sepsis
G E Catt
 Renal
losses

Burns

Reed
Intrisic

I
Interstitial
Glomerulo ATOM
nephritis
nephritis
ytoxinsI Endotoxin
Leptoppivosi

Exotoxins NSAIDs
Hemoglobinurio
contrast material
ADM Myoglobinuria

Colistin rhabdomyolysis

cephalovidine TLS
non oliguria a v Acid
AG
Amphotericin B AKI

Cyclosporin
 C
Una sr.mx00
fraction excretion pre Renal Intrinsic Renal
Ot Not
I
Fema I
72200
410mmol L
Or Not
350
500
Ur
Off
21 DI
Renal failure
index
210 15
BUN Sr.LV
720

Neutrophil W0k
Gelatinase

passociatedtipoulynd su kta CBP

Sr Cra
NGALA
em

iAnemiacystatin.ca sg.Yqg
Kim sa
Hemolytic
Pattern
 g
m my

I in 3 5days Eosinophilia
peak Matt Eosinophilur
Throboemboli
I in 5 7 days Cott
Normal ABI dls

MetabolicAcidosis

Due to did excretion of

Mt N

NI

NLabetolol for
HIM

In
Rhabdomyolysis Tumorlysis fluid
CIN
syndrome overload
Doc forced alkaline t
I
Acetyleystein diuresis water
pasburicase
IVF MS
Allopurinol Diuretics

except
IVF INS
 I

Acidosis Akl
EwtroyteAbnormaliti

MaHcozCivlItIt.t 4
4mg ppg fat
t t t
t
symptomatic Mg sevelamer Cocos

Antacids

I
3 1
I Al OH
Avoided
calcium
acetate

IA
Salbutamol potassium
DOC Insulint
Neb
binders
Calcium Dextrose 1

Gluconate t sodium polystyrene

1 Earliestly sulfonate
will not 1kt Quick Ale Intestinal
I necrosis
 stabilizer shift Extracellular
patiromer
Kt to Intracellur Acetate
Sodium
Zirconate

AKP
Indicationsotpiakpis
I

EPÉIpewdif
I
m
Acidosis volumed
Hyperut
paying
peppy peppy peppy
Encephalo
tory
pathy
Elevated BUN
735mmol

Chronicrendraild

Albuminuria
GFR N 90 120melmin 1.73m
630
 Mg g
1
5 1 S 2
3 5 the
59 I At Az Az
t I 30
15 29 Ly I
90 go.gg t
230 30 300
ESRD
32
th to 7300
Dialysis
415 30 44
59 mg g
kidney Tx

Definition CRF

proteinuria
GFR
260mA min 1 73Mt

this
 ed
Etiology

I 11ft vascular
MIC Glomerular cystic obstructive
t dis dis nephropathy dis
DM I I
BPH
Glomerulonephritis
Mephrofithiasis
PCKDIS
RAD
HTM

Nephrosderosis

e
t.tt
features features Anemia Iced AP
I 1
Of uremia of fluid Vit Dte
IEPO redresorptio
overload
I
 Renal osteodytro
similar to Aki phy

GroFthretardation

Cd
otherfeatures

III Aurea
ped bleeding a infections Dyslipidemia
p neuropathy
to tied him
tendency
grand Impotence
protein upas
age
Thrombocytopenia
function I Glucose
sp Gr urine
I
sp Govplasm
Excoriation y

Mails HalfHalf
n
Ecchymoses
nail
Lindsay's nail

Proximal 112 pale

Aed Capillary
Distal 12 Dark
density
 AI CRI
present
past Ho Renal Absent

dis
Absent present
sustained a

Sv er I 3months
Present
Not present
Anemia
Usually
except Hemolytic

anemias

Absent present
Neuropathy

Absent present
Band Keropathy
corned

Absent present
small kidneys
Except Pools

Myeloma DM
 Lymphoma Amyloidosis

McMD

I It

BP for
HDAC 27
under control anemia
t
I

t t
statins f
Insulin ace s
Evythropoit

Labetolol wit D suppl

go g er z

for I I
NO ACEH's Cinacoucet Darbepoitin
A

Epoitin a

Mice weekly

R Electrolyte abnormalities
 LRT EEP
1
It
Kidney
Dialysis Tx
1
t peritoneum
p membrane
HD
Dextrose rich
I
11mi
to Thrombo Mc
Fistula

I
Phlebitis comp Alternatively

RAHM I day
artificial
3 times a
CiminoBrescia membrane Hypone
week
fistula x

other complications

It
 Recurrent Loss of A Amyloid
HD By
1135

agggy am.gg p iggy

y

Dialysis disequilibrium
syndrome

Kidn

t.ie
Allogenic HLA s.DOnorLt Tests
To Avoid
rejection
Tx Matching kidney HIV
Gene 6 HBV
1st degree Long renal cap
Blood H
relative Vad
Cyclosporine
grouping
renal
Gene a Reapidt Azathioprine
doppler
Rt iliac
to do prednisolone
fossa
I
 TO A Immune
ped opportunistic the system
infections

Nephroticsyndromed

FA
Proteinuria Albuminuria p edema Hyperlineg
Mia
7359124hr
Lipiduria

Hyper
3 Characteristic coagulability
Features

excreted
otherproteins

I It
Globulin Transferrin Cholecalciferol cerulo AT I
t t binding Pth plasmin pin c s

t t t
 g
t cott copper Hyper
Infections Coagulabil

HyperupidemiaO Chol
ATG
tha
Aed Renal vein
thrombosis IHDL

Nephroticsyndromed

A t
man Amyloi
Minimal focal dosis

I
segmental
change
Glomerulosderosis
dis

1 IM Elderly
x
Mc Adults
Mcsystemiedls
Children G
Nephrotic syndrome
young Adults
 Diab
hvopounyIift.t

Micro other
7 T pm TDM kidney
vascular Renae
Abac size
Complication
Early A TARTA

red risk Later te papillary

In DM
necrosis
4
of contrast nephropathy
Chronic
interstitial nephritis

In 1st stage of D Nephropathy 7

Early
Hyperfiltration a in the
GEL
Iflb o 54ns
30 Microalbuminuria
300mg day 5 tours

Normal Albuminuria 230mg 24hrs4

BM
D 300mg 24hr5
Macro Albuminuria
 All diabetic pins yearly screening

Albuminuria
t
DIS in early stages

Biased
D 7 7 Modular
Diffuse Glomerulosderosis
Glomeruloscleros

t
Earliest

MC Ivarious
Pathognomic
changes
DM
exudative Kimmel Steil wilson
capsular fibrin caps
lesions
drops
Inter capillary
Glomerulosclerosi

Screening Albumin excretion rate

 U b e I
I T ratio
urine spot spot sample
Albumin

w T
1 intraGlomerular
pressure

I
DOC ACE
fmoatIg
SALT 2 For DM
stop metform

GFR 30
io poe
Is 6

I ARBs I 1 AE
To prevent
ga
Tok
t
proteinuria progression
HDAC

DPP 4 P's

Gtiphins

1 analogues part of
Glp Glomerulus
 _FasegmentÉus
Few
Glomeruli
odoates
1Damagetohe.gg
zefSGSJefSGS
It other
in podocyte protein Infections Drugs
Detect
cocaine
obesity
to HIV
HBV palmidronate
Mutation APOL I gene Alports
HPV Heroine
Eddition sickle

cella

t
At
Hematuria
Hyperlipidemia 501 Hen Proteinuri
te
Renalfailure I
Cola coloured mon
yea yea
ache
proteinuria
 Ioc Biopsy from corticomedullar
junction
4
Is superficial biopsy
Diagnosis missed

IT
EM FM
LM
t
to
to
Hyaline deposits No IgG
part of 3
Podocytes Effaced
Glomerulus involved
Detached
vacuolization

Urine Microscopy RBI

ye
It
sympomatic R
f
f
R Course
Doc Steroids prednisone
 Resistance Intolerant
to
calcineurin es's q

Mycophenolate motel

Membranoused Me in Elderly

IIe Misc
Autoimmune Neoplasia Drugs
Infection
dls t t t
t t DM
co Lung NSAIDs
Hep Bic RA sarcoido
Breast Gold si
SLE
Leprosy PensitiFamine
colon GBS
Sjogren's
syphilis

presentation Elderly Geriatric

t n
ATM Renal vein Edema Renal
Non
 f
selective thrombosis
periorbital t
y
edema
proteinuria x
post
MCC of RUT renal
post
venal AKI
MEI
ARF

A 10C RendDiop

LM iI.EM FM
to
I t
Diffuse thickening Irregular dense IgG
deposits
Cz
Of GBM
sub epithelial
deposits

urine mle oval fat bodies

BUM El Sr er Aed

PET Scan Malignancy

 I It
symptomatic DOC
steroids Cyclosporine
R
Cyclophosphamide
Diuretics

Tacrolimus
ACE ES's

73.59124hr
MhuiMehrii C 39 24hr5
Pfnuvia
Heil
HIM
Hematuria tent
Absent except in

FSGS

proliterativeld
 I
Rapidly
Nephritic syndrome
G
H BY
e
progressive

failure crescents sub Acute Rf

Acute Renal
t
E in Weeks week to months
days Half moon

shaped
Lecionotinflammatory cells
t
RBC RBCcast
Nephritic urinary sediment
MBC
Subnephrotic proteinuria 39124hr

oliguria 400m1124hr5

Edema
ATN

Etiologyotnephriticsyndromed

II
Multisystem Drugs
Infections
dis t
I 1
 1 E Good Pasteur penicillamin
eyndro
PSGM.P AN

Ig A Nephropathy
Beurger's dls Bgyger
A HSP
t vasculitis

TAO Medium IN G

SLE

Goodpasteursyndrod

1 7
Component
Type 2 HSR
Autoimmune dis
Glomerular 43Chain of
a q Type 4
A BM
6 it collagen
f

Diffuse Lung
focal necrosis Alveoli

injury
 Hemoptysis
Hematuria
Ole
other features of Bk pulmonary
Nephriticsyndyme infiltrates

Cogs

It
Gold standard Diagnosis x Ray
serology
fr
Ab Blt
Biopsy kidney
sensitivity proliferative GN
infiltrates
Diffuse
907 Intra
Crescents 7501 Of
Alveolar
Glomeruli
hemorrhage
If Linear deposits
 Q
th
I mob
Cyst line azathioprine
hIp.ly
or gygj

corticosteroids t

I it
20 to Ag Ab comple
me in
GABA Streptococcal children
Throat skin imf kidney
f
I I
PSGN
Winter summer

serotype 3 HSR
serotype Type
 12 49
pharyngitis Impetigo

Latent period

f 3 Wks 3 61141

tea Renal
Hematuria Edema HTM Lvf
1 failure
Cola coloured Dyspnea
urine
palm edema

1dork No role of culture

II 10C
Urine serology
analysis to
ASO N
yBiopsyd
I
RBC
 I
th EN th
RBC Copts A anti pilaase
t
Leucocyte
protein sub
A AHoyse epithelial
infiltration

Su complement 3 f neutrophilsdeposits

Transiently I 2weeks crescents

Iggy ez
poor
IMormal I
Prognosis
I in 4 8 weeks
starrysky
appearance

Is
G Brain USG Abdomen LM biopsy

te
te te
Ncc Viral Burkitt's
Hepatitis

IIe
Symptomatic R No vole of Prognosis
Good
HTM Labetolol Antibiotics
 O Recurrence
Diuretics
Less

IgA Nephropathy Berger's dls

G MADE Fin
t
2 4 days after
1st line of
GI ORJI Inst antibody is
defense
formed

I
Glomerulo Glomeruld
nephritis I
I Mesangium

Iganephropathf Mesangioproliterati

GN

I off Bp Normal 20 Got

Recurrence Recurrent
pins
common Gross 1
Hematuria progress to
 ESRD
over 2048s

period
10c RenalBiop

iL.M FEM FM
t
t t
Mesangiong ga
Mesangial
Mesoingium

f
Paramesongiod
Proliferation
deposits

No role of Sr IgA
sine qua non
levels Diagnosis

SV Cz Normal

steroids 9 Is Azathioprine
Cyclophosphamide Luvs
t
3months

Iga nephropathy PSGN

Hematuria
onset of hematuria
7 21 doge
2 4 days infection

following Url
Skin inf
Rare
Recurrence very
Common
I Transiently
Serum Cz Normal

ASO A
Aso titer Normal
 Rendarterysterosid

Elderly
ound
I F
Atherosclerosis
India Western
fr
Takayasuarteritis
fibromuscular
dysplasia

presentation

A Renin BIL RAS Ole Work Up

Abdomen
1st line
51 soy pins I
20 HIM
056 Abdomen
Bruit
LVF I
t 1 systole a
Asymmetric
elf Headache Dyspnea Diastole kidney size
due to voiviatio
 1
Pulmonary edema 15am

R Koopdiuretics I dose Best screening

I test Ra doppler
flash pulmonary
10C Renal
edema
Angiography
Gold standard invasive confirms

the diagnosis

Inv to be Avoided MRI

I
Nephrogenic fibrosis

IIe for
UIL RAS for BIL CCBs I
fibromascula
t RAS
Labetoll dysplasia
ACE es's 1
Atherosclerotic te
ACE ti's are
RAS I PTRA
Contraindicated
 statins percutaneous

Transluminod
Anti HAMS
renal Angioplasty

Rend_ubularACid0

Rye pya.y
4 HAGIA
Both Type I HypercholremicNgAn

ytyYe f33type.g
Type 2 Type 4
Type I
site of pathology

Distal RTA
Proximal RTA DL
absorption

failure of It failure of 165 Aldosterone

or
secretion in pet
ion
Aldosterone
in piswame.ya.aoa
sresistane.I
Glucose abs
 Noni's Anemia

Aplastic
pancytopenia Fanconi's syndrome
E ogy

DM Mcc
B Acetazolamide
Amphotericin
ACEC s
paraproteinemia ARBS

Spironolactone

pep pentamidine
PIP
TRAPTSMX
LE
potassium
4kt Mkt
1kt

urinary ph
5.5 75 5
5.5

Renal stone NO
NO
yes
 oat

Maltloz Fludrocortison
R MOHW3
10 15MegKg
1 2 meal kg

GPS Hereditarydised kidney

13,1T
LIDDIES A

BARTERSGitelmannsf.tn
chain of
5 TYPED
Type 4 collagen
Kidney
TR Dug
Ear

In
Hereditary Ear Eye
nephritis Smith Anterior
Gil FSGS Mc Extra renal Lenticonus
BIL
Hematuria abnormality
corneal
progressive Assymetrical
erosions
 renal failure corneal
opacities
cataract
Retinal
detachment

polyceptickidneydised

11Interitedd AR
AD f
1 Children
more common
Adults
GEROTA

1 Itt
6th Gene sized
Asymptomatic By 5th pathology
mutation te
decade cysts
opto 3rd 4th Chronic
PKD 17
cortex
decade Esrp ch lb flank
PKD 2 7 Medulla pain

Ch 4 Strawcolour
 Fluid

Med Risk
taHematuria urate Red
Chronic risk
of 071 stone
flank y of RCC
cyst infected 751 Izoy I
pain
to Blt
arenin
AcuteAbdominal
ESRF 5th 6th decade
pain

Extra
ped Renat

In CUS
5 GIT
Its I
Liver Me Berry Gl polyps
MVP
Aneurysms
spleen colonic Triasp
pancreas salt diverticulosis
regurgi
tatio
 ares nerd
Ba enema
polichoectasias
sanetoothed

Malformation vasculature appearance

street
Brain

W0rk

10C
1st line 10C to
To confirm
confirm the number
the A
USG Abdomen of cysts
te
te
C Abdomen
Genetic
analysis

III ESRD
ACE G's Lipid Tramadol Transcutaneous
t
soluble to Pain electrical
for ten
kidney
Antibiotics µ pacing
Tx
Target BP te y
2140190 Quinolone t pain stimulus
f
prevent progression Sirolimus Brain

Tolvaptan
Octreotide