ABC of Kidney Disease
David Goldsmith, Satish Jayawardene, Penny Ackland, David Goldsmith, Satish Jayawardene, Penny Ackland
- English
- ePUB (handyfreundlich)
- Über iOS und Android verfügbar
ABC of Kidney Disease
David Goldsmith, Satish Jayawardene, Penny Ackland, David Goldsmith, Satish Jayawardene, Penny Ackland
Über dieses Buch
ABC of Kidney Disease
ABC of Kidney Disease, Second Edition
The ABC of Kidney Disease, Second Edition is a practical guide to the most common renal diseases to help healthcare professionals screen, identify, treat and refer renal patients appropriately and to provide the best possible care.
Covering the common renal presentations in primary care, this highly illustrated guide provides guidance on symptoms, signs and treatments, which tests to use, measures to prevent progression, and when and how to refer. Fully revised in accordance with current guidelines, it also includes organizational aspects of renal disease management, dialysis and transplantation. The appendices contain an explanatory glossary of renal terms, guidance on anaemia management and information on drug prescribing and interactions.
The ABC of Kidney Disease, Second Edition is an ideal practical reference for GPs, GP registrars, junior doctors, medical students and for anyone working with patients with renal-related conditions.
About the ABC series
The new ABC series has been thoroughly updated, offering a fresh look, layout and features throughout, helping you to access information and deliver the best patient care. The newly designed books remain an essential reference tool for GPs, GP registrars, junior doctors and those in primary care, designed to address the concerns of general practitioners and provide effective study aids for doctors in training.
Now offering over 70 titles, this extensive series provides you with a quick and dependable reference on a range of topics in all the major specialities. Each book in the new series now offers links to further information and articles, and a new dedicated website provides you with even more support.
The ABC series is the essential and dependable source of up-to-date information for all practitioners and students in general practice.
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Information
Diagnostic Tests in Chronic Kidney Disease
- Urinary protein excretion of <150 mg/day is normal (∼30 mg of this is albumin and about 70–100 mg is Tamm-Horsfall (muco)protein, derived from the proximal renal tubule). Protein excretion can rise transiently with fever, acute illness, urinary tract infection (UTI) and orthostatically. In pregnancy, the upper limit of normal protein excretion is around 300 mg/day. Persistent elevation of albumin excretion (microalbuminuria) and other proteins can indicate renal or systemic illness.
- Repeat positive dipstick tests for blood and protein in the urine two or three times to ensure the findings are persistent.
- Microalbuminuria is an early sign of renal and cardiovascular dysfunction with adverse prognostic significance.
- Non-visible haematuria (NVH) is present in around 4% of the adult population—of whom at least 50% have glomerular disease.
- If initial glomerular filtration rate (GFR) is normal, and proteinuria is absent, progressive loss of GFR amongst those people with NVH of renal origin is rare, although long-term (and usually community-based) follow-up is still recommended.
- Adults aged 40 years old or more should undergo cystoscopy if they have NVH.
- Any patient with NVH who has abnormal renal function, proteinuria, hypertension and a normal cystoscopy should be referred to a nephrologist.
- Blood pressure control, reduction of proteinuria and cholesterol reduction are all useful therapeutic manoeuvres in those with renal causes of NVH.
- All NVH patients should have long-term follow-up of their renal function and blood pressure (this can, and often should be, community-based).
- Renal function is measured using creatinine, and this is now routinely converted into an estimated glomerular filtration rate (eGFR) value quickly and easily.
- The most common imaging technique now used for the kidney is the renal ultrasound, which can detect size, shape, symmetry of kidneys and presence of tumour, stone or renal obstruction.
Symptoms | Signs |
Tiredness | Pallor |
Anorexia | Leuconychia |
Nausea and vomiting | Peripheral oedema |
Itching | Pleural effusion |
Nocturia, frequency, oliguria | Pulmonary oedema |
Haematuria | Raised blood pressure |
Frothy urine | |
Loin pain |
Urine Testing
Pink–red–brown–black | Yellow–brown | Blue–green |
Gross haematuria (e.g. bladder or renal tumour; IgA nephropathy) | Jaundice Drugs: chloroquine, nitrofurantoin | Drugs: triamterene |
Dyes: methylene blue | ||
Haemoglobinuria (e.g. drug reaction) | ||
Myoglobinuria (e.g. rhabdomyolysis) | ||
Acute intermittent porphyria | ||
Alkaptonuria | ||
Drugs: phenytoin, rifampicin (red); metronidazole, methyldopa (darkening on standing) | ||
Foods: beetroot, blackberries |