Renal Medicine – Common Topics
Learn the Mnemonics
1. CKD – stages and eGFR, Urea, Creatinine
3. AKI- causes
4. AV Fistula
5. Renal Osteodystrophy
6. Nephrotic/Nephritic Syndrome
1. CKD (the progressive, irreversible deterioration in renal function) – what symptoms will you enquire about?
· Abdominal Pain
· Pruritis (due to increased phosphate)
· Breathless – anaemia/fluid retention and LVF
· Fatigue is very prominent
· Gout – urate
· Stocking neuropathy via retention of beta-2 microglobulin
The P’s – Pigmentation, Pruritus, Pulmonary Oedema, Peripheral Neuropathy, Painful big toe, Pericarditis, Parathyroid overactivity.
BIG BEAN – Breathless, Itchy, Gout … Bone Pain, Energy Levels low, Ankle Swelling/Anaemia, Neuropathy.
· AEIOU indications – "A"- intractable acidosis; "E"- electrolyte disarray ( K+, Na+, Ca++); "I" - intoxicants (methanol ethylene glycol, Li, ASA); "O"- intractable fluid overload; "U"- uraemic symptoms (nausea, seizure, pericarditis, bleeding)
3. AKI – Pre-renal/Renal/Post Renal, ABCD of AKI treatent (see AKI topic on the forum). DIPSTICK THE URINE – why?
How would you investigate AKI?
· ABG – see the acidosis
· Bloods – FBC/U&E/Creatinine/Blood Cultures
· Catheter to assess fluid balance
· Dietary protein restriction + Dipstick the Urine
· Electrolytes and ECG (look for high K+)
· Ultrasound to exclude obstruction
4. AV fistula – what is this? Dilated veins with scars at the wrist? Bruit over the fistula. What are the different types of dialysis? What other options are used for ACUTE dialysis/CRRT needs? What is peritoneal dialysis?
5. Renal Osteodystrophy – osteoporosis, hyperparathyroidism, osteomalacia, osteosclerosis (rugger jersey spine). Could you talk about calcium metabolism (see electrolyte topic on forum + PDF).
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