Nephrology 1
Prerenal AKI FENa
<1%
Serum anion gap calculation
Serum Sodium – (Serum Chloride + Serum Bicarbonate)
Acute respiratory acidosis compensation
1 mEq ↑ HCO3 for each 10 mm Hg ↑ PCO2
Most common genetic markers for ADPKD
PKD1 and PKD2 genes
Common presentation of anti-GBM antibody disease
RPGN plus pulmonary hemorrhage
ATN FENa
>1%-2%
Urine anion gap calculation
(Urine Na+ + Urine K+) – Urine Cl-
Acute respiratory alkalosis compensation
2 mEq ↓ HCO3 for each 10 mm Hg ↓ PCO2
Initial screening for ADPKD
Ultrasonography
Pathology findings in RPGN
Extensive glomerular crescents
Urine sediment in ATN
Pigmented granular or muddy brown casts and tubular epithelial cells and casts
Albumin-corrected anion gap calculation
Anion Gap + 2.5 × (Normal Albumin − Measured Albumin)
Chronic respiratory acidosis compensation
3.5 mEq ↑ HCO3 for each 10 mm Hg ↑ PCO2
ADPKD-associated intracranial manifestation
Aneurysms
Treatment of anti-GBM antibody disease
Plasmapheresis, glucocorticoids, cyclophosphamide
Compensation for metabolic acidosis
PCO2 = (1.5) [HCO3] + 8 ± 2
Diagnosis for anion gap acidosis and Δ-Δ ratio <0.5-1
Concurrent metabolic acidosis
Chronic respiratory alkalosis compensation
4-5 mEq ↓ HCO3 for each 10 mm Hg ↓ PCO2
Glomerular disease, sensorineural hearing loss, ocular disease
Hereditary nephritis (Alport disease)
Most common cause of RPGN in older adults
ANCA-associated glomerulonephritis
Δ-Δ ratio calculation
(Anion Gap − 12)/(25 – Bicarbonate)
Diagnosis for anion gap acidosis and Δ-Δ ratio >2
Concurrent metabolic alkalosis
Compensation for metabolic alkalosis
1 mEq ↑ HCO3 results in 0.7 mm Hg ↑ PCO2
Benign hereditary glomerular disease, hematuria, minimal proteinuria
Thin basement membrane disease
Infection most commonly associated with cryoglobulinemia and membranoproliferative glomerulonephritis
Hepatitis C