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1.2 Cardinal Manifestations of Renal Disease DR Mora
1.2 Cardinal Manifestations of Renal Disease DR Mora
of Renal Disease
• Electrolyte abnormalities
• Fever / pain
Critically important renal abnormalities
• Assessment of GFR
• Assessment of GFR
• Cockcroft-Gault equation
• Assessment of GFR
• Cystatin C
eGFR calculator downloadable for free at Play Store (Android) and App Store
(Apple)
Compute!!! Patients Have Different eGFR at the
Same Level of Creatinine
eGFR by CKD-EPI
(mL/min/1.73m2) 95 60 47
• Prerenal failure
• Postrenal azotemia
• Causes:
MAP
SNS(+)
RAAS(+)
AUTOREGULATION
ADH release (afferent: relax
efferent: constrict)
Maintain BP
Maintain GFR
Restore cardiac &
cerebral perfusion
GFR depends on diameters of afferent and efferent arterioles
Glomerulus
GFR GFR
Glomerular filtrate
• Requisites:
• Involves:
• Large renal vessels
• Intrarenal microvasculature and glomeruli
• Tubulointerstitium
Glomerular Barrier:
• Glomerular endothelial cells
• Glomerular basement
membrane
• Podocytes with “slit
diaphragm”
• Tubular proteinuria
• Normal:
• Isolated hematuria
• Bleeding from the urinary tract
• Stones, neoplasms, trauma, infection (TB, prostatitis)
• Menstruation, viral illness, allergy, exercise
• Hypercalciuria, hyperuricosuria
Evaluation of hematuria
• 3 most common:
• IgA nephropathy
• Hereditary nephritis
• Thin basement membrane disease
• Renal biopsy
Thank you !