Nephrology 1
Elements of the nephrotic syndrome
Proteinuria >3500 mg/d, hypoalbuminemia, hypercholesterolemia, edema
Early ECG signs of hyperkalemia
Peaked T waves and shortened QT interval
Type 1 (hypokalemic distal) RTA treatment
Potassium citrate or potassium bicarbonate
Treatment of hypertension with DM and albuminuria
ACE inhibitor or ARB
Dipstick results predictive of UTI
Positive leukocyte esterase and nitrates
Standard treatment of the nephrotic syndrome
ACE inhibitor or ARB, diuretics, statin
Urine anion gap calculation
(Urine Na+ + Urine K+) – Urine Cl-
Drug therapy for arginine vasopressin deficiency
Desmopressin
eGFR threshold to begin loop diuretic for BP control
<20-30 mL/min/1.73 m2
Gold-standard diagnostic imaging for nephrolithiasis
Noncontrast helical CT
Urinalysis clues for glomerular hematuria
Dysmorphic erythrocytes, erythrocyte casts, proteinuria
Compensation for metabolic alkalosis
1 mEq ↑ HCO3 results in 0.7 mm Hg ↑ Pco2
Hypernatremia, elevated serum osmolality, inability to concentrate urine
Arginine vasopressin disorder
Decreased kidney function and diuretic-resistant HF
Cardiorenal syndrome
Treatment of alcoholic ketoacidosis
Thiamine followed by 5% dextrose in saline
Diagnostic tests for IgA vasculitis
Kidney or skin biopsy
Δ-Δ ratio calculation
(Anion Gap − 12)/(25 – Bicarbonate)
Isovolemic hypotonic hyponatremia and urine osmolality <100 mOsm/kg H2O
Psychogenic polydipsia or poor solute intake
Initial screening test for primary aldosteronism
Primary aldosteronism concentration (PAC) and plasma renin activity (PRA)
Medication to prevent preeclampsia in pregnant patients at high risk
Aspirin starting after 12 weeks of gestation
Diagnostic test for lupus nephritis
Kidney biopsy
Metabolic alkalosis, normal volume status, urine chloride >15 mEq/L
Diuretic use, Bartter and Gitelman syndromes
Diagnosis for normal anion gap metabolic acidosis with positive urine anion gap
Distal RTA
Hepatorenal syndrome treatment
Stop diuretics; start albumin; start terlipressin or midodrine and octreotide
Definitive treatment for preeclampsia
Delivery