This is defined as chronic kidney disease
What is eGFR < 60 for at least 3 months
Uric acid crystals in large amount suggests this
What is tumor lysis syndrome
A 4-year-old boy is brought to the clinic due to sudden periorbital swelling, abdominal distension, and frothy urine following a viral upper respiratory infection. Lab work shows severe hypoalbuminemia (1.8 g/dL) and 4+ proteinuria without hematuria. Light microscopy of the renal biopsy appears normal, but electron microscopy reveals diffuse effacement of podocyte foot processes
What is minimal change disease
Approximately this fraction of the body's total water content is stored inside cells as intracellular fluid
What is 2/3
What is IV calcium gluconate or calcium chloride. It stabilizes the cardiac membrane rather than lower serum potassium.
While anemia is common in both acute and chronic kidney failure, the presence of this specific endocrine disorder points strongly toward chronic kidney disease over acute kidney injury
What is secondary hyperparathyroidism
Unlike radiocontrast nephropathy which peaks within 48-72 hrs of arteriography, this etiology of acute kidney injury presents weeks after vessel instrumentation, characterized by hypocomplementemia, peripheral eosinophilia, livedo reticularis, and intravascular needle-shaped "ghosts" on renal biopsy
What is atheroembolic renal disease or cholesterol crystal embolization
Beyond blood pressure control, ACE inhibitors and ARBs are preferred first-line antihypertensive agents in nephrotic syndrome because they lower intraglomerular pressure and reduce proteinuria by selectively dilating this renal vascular structure
What is the efferent arteriole
Specialized osmoreceptors that detect changes in plasma concentration and trigger the sensation of thirst are located in this structure of the brain
What is the hypothalamus
Postoperative administration of hypotonic fluids frequently precipitates acute iatrogenic hyponatremia due to surgical stress and pain triggering persistent, non-osmotic release of this hormone for several days.
What is arginine vasopressin (AVP/ADH)
Beyond standard clinical risk factors, genetic susceptibility to progressive hypertensive renal disease is heavily linked to variant alleles in this gene
What is APOL1
Magnesium ammonium phosphate crystals often suggest infection with these organisms
What is Proteus mirabilis or vulgaris, Klebsiella pneumoniae, S. saprophyticus (urease-producing organisms)
A 22-year-old man presents with dark, tea-colored urine and mild hypertension 48 hours after the onset of a sore throat and fever. Urinalysis reveals dysmorphic red blood cells and red blood cell casts. Expected serum C3 and C4 levels are
What is normal
Unlike sodium and glucose, elevated urea in uremic patients fails to induce cellular fluid shifts because it acts as this specific type of solute
What is an ineffective osmole
Although measured serum sodium appears falsely low, plasma osmolality remains normal in this clinical artifact. The clinical artifact is caused by this.
What is pseudohyponatremia. Clinical artifact caused by reduced proportion of plasma water relative to plasma solids (hypertriglyceridemia or hyperglobulinemia)
Serum creatinine concentration does NOT rise to above the population threshold (1.3 mg/dL in men and 1.1 mg/dL in women) until approximately this percentage of kidney function is lost
In earlier stages of kidney disease, this is what maintains serum creatinine in the normal range
What is: 40%
Serum creatinine is maintained by enhanced tubular secretion of creatinine
When assessing intrarenal hemodynamics via cortical pulsed Doppler imaging, an elevated value exceeding this specific threshold indicates that endovascular revascularization is unlikely to improve BP or halt GFR decline
What is a resistive index (RI) of 0.8
This is characterized by simultaneous positive staining for IgG, IgM, IgA, C1q, and C3 on immunofluorescence, described as a "full-house" pattern.
What is Lupus nephritis
An osmolar gap exceeding 10 mOsm/L unmasks the presence of unmeasured, exogenous toxins. In a patient with severe anion gap metabolic acidosis and acute kidney injury, this specific ingested toxin produces an elevated osmolar gap and characteristic envelope-shaped calcium oxalate monohydrate urinary crystals
What is ethylene glycol
This antibiotic can precipitate hyperkalemia by blocking luminal sodium channels in the distal nephron, similar to amiloride
What is trimethoprim
This is the relationship between serum creatinine and GFR
This increase in serum creatinine is the most significant because
What is as creatinine increases, GFR decreases
An increase in serum creatinine is most significant starting from baseline function.
Ex: A serum creatinine increase from 1 to 1.5 mg/dL is more significant than a serum creatinine increase from 3 to 3.5 mg/dL
To prevent radiocontrast-induced AKI during diagnostic renal arteriography for PAN, clinicians can inject this non-nephrotoxic alternative to visualize characteristic intrarenal microaneurysms
What is CO2
In patients with severe nephrotic syndrome and serum albumin under 2 g/dL, massive urinary wasting of this endogenous anticoagulant protein dramatically increases the risk for renal vein thrombosis
What is antithrombin III
In the standard formula for calculating plasma osmolality, serum glucose measured in mg/dL is divided by this constant to convert the value into millimoles per liter (mmol/L)
What is 18
Calculated osmolality = (Na x 2) + glucose/18 + BUN/2.8
A patient with severe diarrhea develops a normal anion gap metabolic acidosis. The renal collecting tubules respond to this systemic drop in pH by upregulating hydrogen ion excretion, which relies on the availability of this specific urinary buffer to regenerate bicarbonate ions
What is ammonia