RENAL MEDICINE - Common Topics & Mnemonics

​Renal Medicine – Common Topics
Learn the Mnemonics 
 
1.    CKD – stages and eGFR, Urea, Creatinine
2.    Dialysis
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?
·      Urination
·      Oedema
·      Abdominal Pain
·      Eyesight
·      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.
 
2. Dialysis 
·      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).