summarizing nephrology

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SUMMARIZING NEPHROLOGY DR SAIMA NAQVI

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Page 1: Summarizing nephrology

SUMMARIZING NEPHROLOGY

DR SAIMA NAQVI

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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.

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CHRONIC RENAL FAILURE

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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 ” 

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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

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• 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.

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WHAT IS THIS?

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PICTURE DIAGNOSIS?

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