KIDNEY DISEASES OVERVIEW

1. Diana May B. Laraya, MD
Internal Medicine
Kidney Diseases and Diuretics

2. Major Syndromes in
Nephrology
 Nephrotic Syndrome
 Nephritic Syndrome
 Acute or Rapidly Progressive Renal Failure
 Chronic Renal Failure
 Asymptomatic Urinary Abnormalities
 Urinary Tract Infection
 Renal Tubule Defects
 Urinary Tract Obstruction

3. Nephrotic Syndrome
• Proteinuria >3.5g
per 1.73 m2 per 24h
• Hypoalbuminemia
• Hyperlipidemia
• Lipiduria
Edema
Important Clues to
Diagnosis
Common Findings

4. Nephritic syndrome
• Hematuria, RBC
casts
• Azotemia, oliguria
• Edema
• Hypertension
Proteinuria
Pyuria
Circulatory
congestion
Important Clues to
Diagnosis
Common Findings

5. Nephritic vs Nephrotic

6. Acute or Rapidly Progressive
Glomerulonephritis
• Anuria
• Oliguria
• Documented recent
decline in GFR
Hypertension
Pulmonary
edema
Hematuria
Proteinuria
Peripheral
edema
Pyuria
Important Clues to
Diagnosis
Common Findings

8. Chronic Renal Failure
• Azotemia >3
months
• S/sx of Uremia
• Shrunken,
echogenic kidneys
on UTZ
• Anemia
• Hyperparathyroidis
m
Hematuria
Proteinuria
Edema
Hypertension
Hyperkalemia
Hypocalcemia
Anemia
Acidosis
Important Clues to
Diagnosis
Common Findings

11. Asymptomatic Urinary Abnormalities
• Hematuria
• Proteinuria (below
nephrotic range)
• Sterile pyuria,
casts
Important Clues to
Diagnosis

12. Urinary Tract Infection
Hematuria
Mild Azotemia
Mild
proteinuria
Fever
Common Findings

14. Renal Tubule Defects
• Electrolyte (Na+, K+,
Mg2+, phosphate, or
Ca2+) or solute
(glucose, uric acid,
amino acid)
disorders
• Polyuria, Nocturia
• Structurally
abnormal kidneys
Hematuria
“Tubular
proteinuria”
Enuresis
Electrolyte or
acid-base
disorders
Important Clues to
Diagnosis
Common Findings

16. Urinary Tract Obstruction
• Azotemia, oliguria,
anuria
• Polyuria, nocturia,
urinary retention
• Slowing of urinary
stream
• Large prostate, large
kidney
• Flank tenderness, full
bladder after voiding
Hematuria
Pyuria
Enuresis, dysuria
Common Findings

18. Major Syndromes in Nephrology
 Nephrotic Syndrome
 Nephritic Syndrome
 Acute or Rapidly Progressive Renal Failure
 Chronic Renal Failure
 Asymptomatic Urinary Abnormalities
 Urinary Tract Infection
 Renal Tubule Defects
 Urinary Tract Obstruction

19. DIURETICS

20. Diuretics
 Also called “water pills”
 Mechanism of action  kidneys
 Release sodium and water through urine
 Treatment for hypertension, glaucoma and
edema