1. Renal Function Overview
1.1. Blood pressure regulation
1.1.1. Renin-Angiotensin system
1.1.2. Aldosterone
1.1.3. Anti-diuretic Hormone
1.2. Electrolyte Balance
1.2.1. Na+
1.2.2. K+
1.2.3. H+
1.2.4. HCO3-
1.2.5. OTHER Ca+/Mg+/Zn/Cu
1.3. Fluid Balance
1.3.1. Excess fluid
1.3.2. Urine production
1.3.2.1. Produces approx. 1-2 L per day
1.3.3. Fluid replenishment
1.4. Filtration
1.4.1. ~ 12 times every hour or
1.4.2. ~ 200 litres of blood per day
1.4.3. Waste and metabolic byproducts
1.4.4. Drug elimination
1.4.5. toxins.
1.5. Protein retention
1.5.1. Albumin
1.5.2. Globulins
1.5.3. OTHER
1.6. Production of Vitamin D
1.7. Production of Erythropoietin
2. Diagnostic Workup
2.1. Biochemistry
2.1.1. Urinalysis
2.1.1.1. Albumin/Creatinine Ratio
2.1.1.2. Heamaturia
2.1.1.3. albuminuria
2.1.1.4. Glycosuria
2.1.1.5. ACR
2.1.2. GFR/eGFR
2.1.3. K+
2.1.4. Na+
2.1.5. Acidosis
2.1.6. hypoalbuminaemia
2.2. Haematology
2.2.1. anaemia
2.2.1.1. hypochromic-normochromic
2.2.1.2. microcytic-normocytic anaemia
2.3. Immunology
2.3.1. Antiglomerular Antibodies
2.3.2. autoimmune conditions
2.4. Anatomical Pathology
2.4.1. Biopsy
2.5. Diagnostic Imaging
2.5.1. Ultrasound
2.5.2. CT/MRI
2.5.3. Angiography
3. Presentations
3.1. Non Specific
3.1.1. Tiredness
3.1.2. Lethargy/Fatigue
3.1.3. Weight Imbalance
3.2. Specific
3.2.1. Filtration Defect
3.2.1.1. Polyuria
3.2.1.2. Hematuria
3.2.1.3. Oedema
3.2.1.4. oliguria
3.2.2. Protein Imbalance
3.2.2.1. proteinuria
3.2.2.2. albuminuria
3.2.2.3. hypo-albumaemia
3.2.2.4. hypo-proteinaemia
3.2.3. Ca Metabolism
3.2.3.1. hyperparathyroidism
3.2.3.2. osteoporosis
3.2.3.3. chondromalacia
3.2.4. Toxic Metabolites/Drug Interactions
3.2.5. Uraemia
4. Management
4.1. Dialysis
4.2. Non-Dialysis
5. Drugs
5.1. ACE Inhibitors:
5.1.1. Lisinopril/Ramipril/Captopril
5.2. ARB (angiotensin receptor blockers)
5.2.1. Candesartan/Valsartan
5.3. Antibiotics:
5.3.1. Aminoglycosides
5.3.2. Cephalosporins
5.3.3. Amphotericin B
5.3.4. Bacitracin/Vancomycin
5.4. Chemotherapeutics:
5.4.1. Cisplatin/Carboplatin
5.4.2. Methotrexate.
5.5. Protease Inhibitors Antiviral Drugs (Medicines used to treat HIV)
5.5.1. indinavir (Crixivan)/lopinavir/ritonavir (Kaletra)/nelfinavir (Viracept)/ritonavir (Norvir)
5.6. Illicit Drugs:
5.6.1. Heroin
5.6.2. Methamphetamine
5.7. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
5.7.1. ibuprofen/naproxen/diclofenac/indomethacin/high-dose aspirin
5.8. Proton Pump Inhibitors (PPIs) & H2 Antagonists
5.8.1. Aciphex, Nexium, Prilosec, Prevacid
5.8.2. Pepcid, Tagamet, Zantac
5.9. Supplements
5.9.1. Wormwood oil
5.10. Laxatives
5.10.1. Compounds containing oral sodium phosphate
5.11. Contrast Dyes
5.11.1. Iodinated compounds (CT contrast): Lipiodol/Utlravist
5.11.2. Gadolinium contrast media (sometimes called a MRI contrast media, agents or ‘dyes’)