Answers
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Acute kidney injury (AKI)/acute renal failure is a deterioration in renal function over hours to days. Acute-on-chronic renal failure is a deterioration in the renal function of a patient who has an element of chronic kidney disease. The causes of acute kidney injury are classified as prerenal, renal and post-renal. Pre-renal causes result in hypoperfusion of the kidney, e.g. hypovolaemia, cardiac failure and sepsis. Renal causes may be due to acute tubular necrosis (often secondary to many of the pre-renal causes), vascular disease (e.g. vasculitis), glomerular disease (e.g. glomerulonephritis) and drugs. Post-renal causes are any cause of urinary tract obstruction, such as BPH, prostate cancer, renal calculi and tumours of the urinary tract. A renal ultrasound can rapidly and reliably rule out an obstruction. Management is by treatment of the underlying cause.
Rheumatology
Stephan Strobel, Lewis Spitz, Stephen D. Marks in Great Ormond Street Handbook of Paediatrics, 2019
Renal involvement: typically a focal segmental necrotising glomerulonephritis, with pauciimmune crescentic glomerular changes (Fig. 17.33). The clinical manifestations associated with this lesion are: hypertensionsignificant proteinurianephritic and/or nephrotic syndromeother manifestations of acute kidney injury and chronic kidney disease.
Roman Medicine
Arturo Castiglioni in A History of Medicine, 2019
Special pathology is treated in the Hippocratic sense, but one also finds noteworthy observations that seem to come from other sources. Hemorrhage from the mouth is regarded as a symptom of laceration of the nose or oesophagus when it is not accompanied by fever, headache, or pain in the chest. A thick urine with a white sediment is regarded as a precursor of arthritic pain. Micturition, drop by drop, and hematuria with violent pains in the pubic region announce an affection of the bladder. Interesting also are the symptoms of kidney disease, in which, according to our author, there are noted: pains in the kidney region, polyuria, vomiting, and urine which is pale and watery, but may. be foamy or bloody or contain gravel. The presence of foamy blood in the sputum indicates a disease of the lungs; Celsus maintains that the prognosis is favourable if the expectoration is whitish and of a consistency like mucus from the nose; but unfavourable if the sputum is purulent, accompanied by continued fever, and if the patient complains of thirst and continued loss of appetite. The end is near when frequent diarrhoeas supervene.
Dialysis vintage is associated with a high prevalence and severity of unpleasant symptoms in patients on hemodialysis
Published in Renal Failure, 2023
Li Zhu, Xun-Liang Li, Rui Shi, De-Guang Wang
Physical and emotional health are important factors in the ability to live, work and study actively. Especially for patients with chronic illnesses, symptoms related to physical and emotional illnesses not only affect the quality of their daily life but also play a key role in the adequacy of treatment for their physical illnesses [1,2]. Research shows that individuals with chronic kidney disease (CKD) experience a significantly higher burden of adverse symptoms, including fatigue and anxiety, compared to the general population. This burden is estimated to be three times greater. Furthermore, the risk of mortality rates and the need for dialysis tend to be higher in CKD patients [3,4]. Despite the higher burden of unpleasant symptoms in end-stage renal disease (ESRD), most dialysis patients often consider the priority of relieving clinical symptoms and neglect the treatment of unpleasant symptom burden, which leads to the under-treatment of somatic illnesses [5]. Therefore, it is crucial to incorporate regular screening for unpleasant emotions in patients with CKD as part of clinical treatment. Providing high-quality care to patients can enhance their self-management skills and medication compliance, improve their quality of life, and significantly alleviate negative emotions [6].
Urinary exosomes derived circRNAs as biomarkers for chronic renal fibrosis
Published in Annals of Medicine, 2022
Yuhan Cao, Yuanhui Shi, Yanlang Yang, Zhangli Wu, Nana Peng, Jie Xiao, Fan Dou, Jingjing Xu, Wenjun Pei, Cong Fu, Pingsheng Chen, Yuwei Wang
Early, accurate and non-invasive diagnosis of renal fibrosis was important in treating CKD. Accurate biomarkers can not only replace traumatic pathological examination but also guided treatment and prompt prognosis. Some studies had found that markers of key biological events in renal fibrosis can be detected before pathological changes appear, and were related to the risk of progression to fibrosis [13]. For a long time, urine had become the main source of non-invasive biomarkers for the diagnosis of kidney disease because it carried a lot of kidney disease-related information. Up to now, it had been found that there were many small cells in the urine, including podocytes and tubular epithelial cells. In 2001, Li et al. firstly established a non-invasive approach to diagnosing acute renal rejection of allografts by isolating and quantifying RNA of specific genes in urine cells [4]. Urinary sediment had attracted researchers' focus and had become an attractive resource for detecting the biomarker for kidney diseases [11,14–17]. However, the current urine cell mRNA detection technology still had some limitations. There were a large proportion of non-renal cells in the urine, such as transitional epithelial cells and squamous epithelial cells. Kidney proper cells such as renal tubular epithelial cells (TEC) and podocytes were mixed in different proportions [18]. mRNA expression level in urine cannot reflect the degree of renal disease accurately [19].
Kidney tissue elastography and interstitial fibrosis observed in kidney biopsy
Published in Renal Failure, 2022
Mehmet Sami Islamoglu, Sibel Gulcicek, Nurhan Seyahi
Because of the high negative predictive value, we suggest that elastography should mainly be used as an exclusion test for the presence of fibrosis. However, we want to point out that because of the low number of patients with fibrosis our results should be confirmed in larger groups. Indeed, the most important limitation of our study was the small number of patients in the fibrosis group, since patients with proteinuria with new onset of chronic kidney disease or developing acute kidney disease rather than the end-stage chronic kidney disease group were included in the study. Despite these limitations, a significant relationship was observed between elastography measurements and fibrosis. If we included the patients with end-stage chronic kidney disease in whom fibrosis is more prevalent, the significant relationship could have been established more strongly. Further studies with more chronic kidney disease patients are needed.
Related Knowledge Centers
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- Kidney
- Blood Test
- Assessment of Kidney Function
- Kidney Dialysis