this presentation is intended for under grad and post grad medical students

1. SUMMARIZING NEPHROLOGY
DR SAIMA NAQVI

2. LEARNING OBJECTIVES
BY THE END OF THIS LECTURE STUDENTS OF FINAL YEAR MBBS WOULD BE ABLE TO
• IDENTIFY HOW TO APPROACH PATIENTS WITH PROTEINURIA AND HEMATURIA.
• APPLY THEIR KNOWLEDGE FOR DIAGNOSING AND MANAGING COMMON NEPHROLOGICAL
DISORDERS IN CHILDHOOD.

3. CHRONIC RENAL FAILURE

6. DEFINITION OF CHRONIC RENAL FAILURE
• EVIDENCE OF STRUCTURAL OR FUNCTIONAL KIDNEY ABNORMALITIES
(ABNORMAL URINALYSIS, IMAGING STUDIES, OR HISTOLOGY) THAT PERSISTS FOR
AT LEAST 3 MONTHS, WITH OR WITHOUT A DECREASE IN GFR, AS DEFINED BY A
GFR OF <60 ML/MIN PER 1.73 M2 ”

10. TREATMENT OF CRF
• NUTRITION.
• RENAL OSTEODYSTROPHY. 0.01-0.05 ΜG/KG/24 HR OF CALCITRIOL. PARICALCITOL AND
DOXERCALCIFEROL
• ADYNAMIC BONE DISEASE.
• FLUID AND ELECTROLYTE MANAGEMENT. HYPERKALEMIA: ORAL ALKALINIZING AGENTS,
AND/OR TREATMENT WITH KAYEXALATE.
• ACIDOSIS. SODIUM BICARBONATE TABLETS
• GROWTH. RECOMBINANT HUMAN GROWTH HORMONE (RHUGH). TREATMENT MAY BE
INITIATED WITH RHUGH (0.05 MG/KG/24 HR) SUBCUTANEOUSLY
• ANEMIA. ERYTHROPOIETIN. DARBEPOETIN ALFA

11. • HYPERTENSION. A SALT-RESTRICTED DIET (<2 G/24 HR), THIAZIDE DIURETICS, ACE
INHIBITORS (ENALAPRIL, LISINOPRIL) AND ANGIOTENSIN II RECEPTOR BLOCKERS
(LOSARTAN), CALCIUM CHANNEL BLOCKERS (AMLODIPINE), Β-BLOCKERS
(PROPRANOLOL, ATENOLOL), AND CENTRALLY ACTING AGENTS (CLONIDINE
• IMMUNIZATIONS. IT IS CRITICAL, HOWEVER, TO MAKE EVERY ATTEMPT TO
ADMINISTER LIVE VIRUS VACCINES FOR MEASLES, MUMPS, RUBELLA AND VARICELLA
BEFORE KIDNEY TRANSPLANTATION.
• ADJUSTMENT IN DRUG DOSE.
• PROGRESSION OF DISEASE.

12. WHAT IS THIS?

13. PICTURE DIAGNOSIS?