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    Shortnote HD2 - 1

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    Pak CU Rx
    Renal

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    Shortnote HD2 - 1

    Uploaded by

    Pak CU Rx
    39 views58 pages
    Renal

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    shortnote HD2 - 1

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    Renal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    39 views58 pages

    Shortnote HD2 - 1

    Uploaded by

    Pak CU Rx
    Renal

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
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    Aarndinintetin egbetnrioatunde abyntninencircarny 150 ni -utintly fu corte murray 1.2 9 ‘ureneukoe glomerulus war proximal tubule Medulla duiwluureneuion loop of henle ,collecting duct uns distal tubule snapviinenl sari 1700 fiat nieeorarufudlan ie tlre tinny furremoade -lfumaqesh nan sina unfinud -sina eet © Renin nuqunvadu * EPO * Active vitD * Aldosterone q9 Na wu blood volume * Antidiuretic (vasopressin) ‘on osmolality horwnnidinn soy osmolality tuileons + Natriuretic hormone isin anrest glomerulus -glomerulus nrexton -proximal tubule Cr rinuinii 0.6.2 mg/dl (Bod) -BUN fini s-1¢ mg/dl Praromeneiluaiuluhann ve hyper catabolic ,UGIB ,protein loading , high dose steroid -cystatin C rnainiio.47-1.09 mg/l sthuei psusiproximal tubule ~ CrCl=( urine Crx urine volume) serum Cr x1440 fein 120 +-25 ml/min Sreabsorbtion snngn 68% gn i ex nglan Ranbraeah descending part of henle reabsorbtion gradi -ascending part of henle reabsorbtion qrNa ,k cl gendinh wifeutus: urea muveunwie aldosterone tu(secretion) K,H -collecting tubule reabsorbtion gandul revaunwie ADH #u(secretio n) K,H AKI / \ 1 : 1 Lastisdhurn (initial phase) Geelu@uslonnns | ‘ Acute kidney injury” 5 5. gohan etl phase) iin cn ~ definition ~ AS. | mayedul tubular uaciiddemwintitndonint | ¢ Vf mathnauite GER annsianncnentiaunin 400 1 Rebumeinagydenoninennsiinenmis 1 wacom te vie 1-250 mano(ditretic phase)tels! | Ser > 0.3 maicin 48 hes sunsniorthigandumsinW Na K duet E Ser 21.6970 base line in 7 cays deme Maw nesinndis SOOO mi/day ustaictiutiu { ae aifle «108.05 ahead ; wantonrdiiawiele eae cee 5 ! Aumnioranesiaflanns wlamuqantasis are | eeieeercane pence thin metand yere hed teste ' 13. nrttenmey wwornuns fanesblsile benanie! ! i pay chur omicad 3 bypocis uscbemanoee fi aTsen a: ' vintraTannumila (dialysis) wwitwist = fp Ure 1 21 some perc enccraepany stun sun tomes f Ss eeee mee nneeeen ne” Sa ween ne nnnn=e (oon ~~ === nn, , : i Stage 1 / Risk Cr ii > 1.5 ori; UO 0.8 mUkg/h x 6h \ t n 1 ' ‘Stage 2 / Injury Cr its > 2.0 bri; UO 0.5 mLikgth x 12h { I say ' 1 “ 7 ; 1 Stage 3/ Fale © Cr iii > 3.0 erin vile Cr > 4 mill Tnnifaewyn baseline > 0.5 mg/dL | H Urine Output 0.3 mUkgin x 24 h sffe anuria x 12 n t t ' + Complete toss of kidney function > 4 wk. t :& 1 t ' Rend, Hioang RRT > 3 mo, } -tubules —> acute tubular necrosis (ATN) AKI 1 ' ' -Glomerulus —> acute glomerulonephitis(AGN) | acute kidney inju ' : interstitium __., acute interstitial nephritis(AIN) ne (ischemia vnisntustas cell 17 O2#15 cell win mulPrinegn ' -nephrotoxins ium contrast naw Cellini cell rn rey andes N sorniu Cellfimenqnannngasiuturiole 1 er ri quidudon turn 1 Writiusasiugs manzorSennes fede? pit ' AGN Fina Be oHy ' Slevnénumuves glomerulus sisi fluid i maciamn i Hive avmdugs GFRanes Rosin angiotensin alicotarone sytees Danvremnns amature ne adrenal hands, i Senrlorevugtiwla macrophages spit sodium 1 neutrophils i Aaonaieresliriuan culation Feanrdustanngs ' Tae neithatn ined tema Ss rear AIN roninwmans intersittial vu NSAID penicillin Murer die hypersensitivity i tui dan aeeenth {than worlanniedulion 1 an iltedimam GFR nee inerscewnine —o J S0dium tuitongs Urea Cr fovinazotemia 1 ‘ 1 y { — Gason \ ; -magavfdludaunneanme sina wi abdominal tumer BPH i ifhiu : : ne . ' hadinnragaiiutun 1 ' ie hydronephr a 1 j Tsevazeention , ' 1 i ! 7 ' { ' Sa ' ' ‘ cr BUN / x ‘ co 7 ween ee --- +--+ 5 +e sphunfifldrwacarieloen 1 dilantin tndimininondinratiuhns 3 Bow srafidararrnsnsrodia (GER) RilndoftebsiNth 1 mevemumnsieaindiesiration 2 nfs lez -mremeutayindiaian: Urine AER > 30 mg/24 m , ACR > 30 mg/g Protein dipstick 2 1+ microalbumin dipstick + -revsmusiniienua dalam -Berradimirtvasundeurhifennvietediminh 12 memunradiedntmatiRinn of mugntitala Ga, Weiter whale amen 13 eenunradeiniondlmasehs Hemmer ian menus isitaiela 14 furs taenalaRuramlgnd ela 2 dsauilsl GFR < 60 mli/min/1.73 m2 Anvieruls 3 ew SS qaterutabiaodletebitly Chronic kidney disease nen 3 x ‘ {| Feratuidengdicodemeanifestuerucismahll GFR ¢edu 1 | glomerular basement membranessinitatwwin 1 Bomeruloscerosisiritirraromrmilnaran i 1 Sesion web matuinra: sviternieidibaake srooniy ' ——— “SLE ! | Arwiuladinge -rheumatoid arthritis ' | vaeadorumfuubuacnciituiitien msfoutn HIV ' 1 srulclennns GER nas Wounrngy NSAID Shcaerun ' I easThuawierins qi tiaha ‘brmmurenofu qollule poly cystic kidney disease i ‘gomeruloscerosis Wheres tu tlaRuvinroguyl CKD Chronic kidney disease 3a sioutrversuy 2 3b Woatuimens 3a thasih 4 Woaiawvmsus 3b vil vascular access: “CAPD -HD “KT ‘ -supportive treatment Lamson: wih Creatinine, Z.ansiiaane:: ‘Albuminuria = protein >1+ ~ iy ‘euseuty GFR yin) vyequigtt nvurpi LDL-C <100 Aisi ACE! unzovde ARB nzunsi BP<130/80 mmHg, 2 Whudusirsene 1 Refer nuunntliela tia GFR annaiannriy 4 wn / wit /7 envuqiramulatauncluiann stage 1. eufumnmnmunihiimrineneesla dovfinne nftedanie Galouvuumndiiontn acim wy nzunmieusnn 1s aunNsEs wihiaurminietoneumanriiinmnisurela 5 Ghininbaintionnumatiinininenune sla #Ultinyemmaitonunsuusinuwininiivimeumnie 2 itd tciascaria eeameataeeeemontacena mpleiedinenatieimaunanse ae . hematuria = RBC ; 5 A Slow progression Aegnitutearnsteunin 20 mg/day keep 140/90 mmHg teagihdluilearnzanarrh 390 mg/day keep 130/80 mmHg. -woaliuerineu ACEIs / ARBs fylitieins (cr faatacow.serum K innrins.s molds / Ly HDAIC< 7% aba orignarnanns 90-190 me/dL. atbwnarinormern < 180 mg/d chins metformin idle GER < 30 ml/min/1.73 m? honmwandie Hb < 13 g/dNuigrn, Hb <12 g/dNatnds “WESAuin Hb < 10 g/ di keep 10-11.5 hiv 13 ef dl Miordns TSAT < ve = 30 % uaz ferritin

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