Asymetrickidneysizessuggestchronic

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Unformatted text preview: als, Antimicrobials, Lithium and ACE inhibitors EVALUATION OF A PATIENT EVALUATION OF A PATIENT • EXAMINATION – Blood pressure – Fundoscopy – Precordial examination – Ex of Abdomen for renal bruits and palpable renal masses – Neurological Ex for Neuropathy, Myopathy – Prostate gland in males and pelvic masses in females EVALUATION OF A PATIENT EVALUATION OF A PATIENT • LAB INVESTIGATIONS – UFR – Plasma Cr and BU and Electrolytes – Ix for anaemia ; Hb % , Blood picture – 24 hr protein excretion – Immunological tests : SLE and Vasculitis – Serum / Urinary electrophoresis EVALUATION OF A PATIENT EVALUATION OF A PATIENT • IMAGING – Renal US Scan : Kidney sizes, Kidney masses, obstructive uropathy – Normal Kidney sizes in PCKD, DM, Amyloidosis and HIV associated renal disease – Asymetric kidney sizes suggest chronic renovascular disease or unilateral developmental abnormality – Spiral CT scan with or without contrast : contrast nephropathy EVALUATION OF A PATIENT EVALUATION OF A PATIENT • RENAL BIOPSY – INDICATIONS – Haematuria with proteinuria – Haematuria with negative cystoscopy / IVU – Proteinuria > 1g /day esp with renal impairement – Nephrotic syndrome in adults – ARF esp Nephritic/oliguric ( after exclusion of pre and post renal causes ) – CKD with radiographically normal kidneys – Renal Vasculitis – Malfunctioning transplant Kidney – Diabetic nephropathy without retinopathy COMPLICATIONS OF COMPLICATIONS OF CKD COMPLICATIONS COMPLICATIONS • • • • • • • Cardiovascular complications Anaemia Renal bone d...
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