Archive For December 31, 2016

AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

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AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

Autosomal dominant PKD is the most common hereditary renal disease in the United States and affects more than 500,000 people. The clinical disorder can be caused by at least three different genes. The most common type, ADPKDI, is carried on the short arm of chromosome 16, and the ADPKD2 gene is carried on chromosome 4….

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Dysproteinemias and Amyloidosis

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Dysproteinemias and Amyloidosis

The most common histologic diagnosis, found in 80% of patients with myelonaa, is cast nephropathy or myeloma kidney. Light-chain deposition disease, occurring in 5% to 10%, and amyloidosis, occurring in 10%, can present as the nephrotic syndrome, which is present in up to 25% of the cases. Patients with cast nephropathy usually present with proteinuria…

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Diabetic Nephropathy

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Diabetic Nephropathy

Diabetic nephropathy is the single most important cause of end-stage renal disease in the United States, with diabetic patients accounting for approximately 40% all patients enrolled in the renal disease program. The cumulative incidence of is 30% to 50% in type 1 diabetes and about 20% in type 2 diabetes, although certain populations of patients…

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Focal Glomerulosclerosis

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Focal Glomerulosclerosis

FGS accounts for 10% to 15% of children and 15% to 20% of adults with idiopathic nephrotic syndrome . Although heavy and edema are usually present at onset, some patients have asymptomatic proteinuria and azotemia, and microscopic hematuria are commonly found at the time of diagnosis. Serum complement levels are normal. Recently, a glomerular permeability…

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DIAGNOSIS AND TREATMENT

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DIAGNOSIS AND TREATMENT

The signs and symptoms of hyponatremia are related to brain cell swelling caused by an increase in the brain water content resulting from water shift from a hypoosmolar extracellular environment. Hence disorders should be considered in any patient who has mental status changes. An assessment of the volume status by physical examination is the most…

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Osmolality Disorders

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Osmolality Disorders

Body fluid osmolality, the ratio of solute to water in all fluid compartments, is maintained within an extremely narrow range. Because water moves freely across most cell membranes, changes in the extracellular fluid osmolality cause reciprocal changes in the intracellular volume. Where the glucose and blood urea nitrogen(BUN) concentrations are expressed as milligrams per deciliters,…

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NORMAL VOLUME HOMEOSTASIS

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NORMAL VOLUME HOMEOSTASIS

Protection of extracellular fluid volume is a fundamental characteristic of fluid and electrolyte homeostasis. The homeostatic mechanisms sense changes in the effective circulating volume(ECV). ECV is difficult to define because it is not a measurable and distinct body fluid compartment. ECV relates to the”fullness” and pressure within the arterial tree. Because only 15% of total…

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Radiologic Imaging of the Urinary Tract

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Radiologic Imaging of the Urinary Tract

The plain film of the abdomen or the kidney/ureter/ bladder view is a to determine renal size and shape. Renal ultrasonography is a more reliable test to determine kidney size, and the film is rarely used for this purpose. Radiopaque renal calculi composed of calcium, magnesium ammonium phosphate(struvite), or cystine are often apparent in a…

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The Major Renal Syndromes

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The Major Renal Syndromes

A patient with renal disease may present with hematuria, nocturia, polyuria, edema. Often, however, the symptoms are nonspecific, and it is not unusual for a patient to present with moderate-to-severe renal insufficiency present. Although the division of clinical manifestations into separate clinical syndromes is arbitrary and overlap exists, classification of the expression of renal injury…

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Acute Respiratory Failure

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Acute Respiratory Failure

The two major functions of respiration are to add oxygen to and remove carbon dioxide from the blood. Acute respiratory failure is the relatively sudden decline in either or both of these functions. If an acute insult is of sufficient magnitude, acute respiratory failure may occur even though lung function before the insult was normal….

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