AN APPROACH TO HEMATURIA. Dr Saima Ali
|
|
- Leslie Powell
- 6 years ago
- Views:
Transcription
1 AN APPROACH TO HEMATURIA Dr Saima Ali
2 Definition Microscopic hematuria hematuria is defined as the presence of 5 or more RBCs per high-power field in 3 of 3 consecutive centrifuged specimens obtained at least 1 week apart. > 5 RBCs / HPF ) Gross hematuria > 2500 RBCs / μl
3 causes Depends upon age,sex and race. AGE; preschooler :Wilms tumor School-aged: post infectious GN SEX; F>>M :>1-2 yrs: UTI F>>M: SLE nephritis RACE; sickle cell disease common in blacks.
4 GLOMERULAR HEMATURIA IgA nephropathy (Berger disease) Alport syndrome (hereditary nephritis) Post infectious GN (poststreptococcal GN) Membranous nephropathy Membranoproliferative GN Focal segmental glomerulosclerosis
5 EXTRAGLOMERULAR HEMATURIA Urinary tract infection Urolithiasis Tumor
6 Hematuria With Multisystem Disease Systemic lupus erythematosus nephritis Henoch-Schönlein purpura nephritis Polyarteritis nodosa Goodpasture syndrome Hemolytic-uremic syndrome Sickle cell glomerulopathy HIV nephropathy
7 False Positive Tests for Hematuria HEME POSITIVE Hemoglobin Myoglobin
8 HEME NEGATIVE Drugs Chloroquine Deferoxamine Ibuprofen Iron sorbitol Metronidazole Rifampacin Salicylates Sulfasalazine Dyes Vegetable/Fruit: Food Coloring
9 history cola-colored urine, facial/body edema, hypertension, and oliguria suggest acute nephritic syndrome A history of recent upper respiratory, skin, or gastrointestinal infection suggests acute glomerulonephritis, hemolytic-uremic syndrome, or HSP nephritis Rash and joint complaints suggest HSP nephritis or SLE nephritis
10 history Frequency, dysuria, and unexplained fevers suggest urinary tract infection, renal colic suggests nephrolithiasis. A flank mass may be a sign of hydronephrosis, cystic disease, renal vein thrombosis, or tumor. Patients with a history of trauma Child abuse must always be suspected in the child presenting with unexplained bruising and hematuria
11 Physical exam Hypertension, body edema, hepatosplenomegaly, or signs of heart failure suggest acute glomerulonephritis. Abdominal masses may be caused by posterior urethral valves, ureteropelvic junction obstruction or tumors Several malformation syndromes are associated with renal disease including VATER (vertebral body anomalies, anal atresia, tracheo esophageal fistula, and renal dysplasia) syndrome.
12 Why anemia occur with hematuria intravascular dilution secondary to hypervolemia associated with acute renal failure hemolysis from hemolytic-uremic syndrome or SLE; blood loss from pulmonary hemorrhage as seen in Goodpasture syndrome maleena in patients with Henoch-Schönlein purpura or hemolytic-uremic syndrome
13 Upper v lower urinary tract hematuria Hematuria from within the glomerulus is frequently associated with brown, cola-colored, or burgundy urine, proteinuria >100 mg/dl via dipstick, urinary microscopic findings of RBC casts, deformed urinary RBCs.
14 Upper v lower urinary tract hematuria Lower urinary tract sources of hematuria associated with gross fresh hematuria, blood clots, normal urinary RBC morphology, minimal proteinuria on dipstick (<100 mg/dl).
15 Glomerular Non-glomerular
16 Acute Poststreptococcal Glomerulonephritis acute nephritic syndrome characterized by the sudden onset of gross hematuria, edema, hypertension, and renal insufficiency
17 Etiology PSGN follows infection of the throat or skin by certain nephritogenic strains of group A β- hemolytic streptococci. M protein is the chief virulent factor
18 pathology Exoantigens Streptolysin O Dnase Hyaluronidase Nicotinamide Adenine Dinucleotidase Streptokinase Are produced Patients react to exo-antigens by producing antibodies
19 pathology Two major sites of infection Upper respiratory tract Skin If infections left untreated, it can lead to poststreptococcal sequelae Acute glomerulonephritis Rheumatic fever
20 Clinical features PSGN is most common in children aged 5 12 yr and uncommon before the age of 3 yr Males are more commonly affected than females. The severity of renal involvement varies from asymptomatic microscopic hematuria with normal renal function to acute renal failure The acute phase generally resolves within 6 8 wk microscopic hematuria may persist for 1 2 yr after the initial presentation.
21 Investigations Urine R/E Serum electrolyte Hb and ESR Complement level Evidence of streptococcal infection Renal function tests
22
23
24 TREATMENT 10 days course of oral penicillin recommended to limit the spread of the nephritogenic organisms. Sodium and fluid restriction Avoid fruit juices Avoid protein
25 prevention Family members of patients with acute glomerulonephritis should be cultured for group A β-hemolytic streptococci and treated if culture positive.
26 prognosis 95 % of children recover completely.
27 Henoch-Schönlein Purpura is a small vessel vasculitis characterized by a purpuric rash, arthritis, abdominal pain, and glomerulonephritis. The symptoms and signs of HSP nephritis typically appear 1 3 wks after an upper respiratory tract infection The prognosis in HSP nephritis is generally favorable, although the risk of chronic kidney disease is 2 5%
28
29
30 Nephroblastoma is the most common childhood abdominal malignancy. The median age at diagnosis of Wilms tumor is approximately 3.5 years.
31 Clinical features Asymptomatic abdominal mass (in 80% of children at presentation) Abdominal pain or hematuria (25%) Urinary tract infection Hypertension, gross hematuria, and fever (5-30%) Rarely Respiratory symptoms related to lung metastases (in patients with advanced disease)
32 diagnosis Renal US Abdominal MRI Supportive RFTs Urine R/E
33 Management Nephrectomy followed by chemotherapy
34 Urolithiasis Urolithiasis nephrocalcinosis
35 epidemiology In children, calcium stones are most common. the boy-to-girl ratio (3:2
36 Etiology Supersaturation of stone-forming compounds in urine Presence of chemical or physical stimuli in urine that promote stone formation Inadequate amount of compounds in urine that inhibit stone formation (eg, magnesium, citrate)
37 treatment A high fluid intake leading to increased urine output is safe and generally beneficial for children with all types of stones, The goal is to lower urinary calcium such that no new stones are formed without producing calcium deficiency. Alkalinizing agents Diuretics- hydrochlorthiazide Xanthine oxidase inhibitors- Allopurinol
38
39
40
41
Dr P Sigwadi 30 May 2012
Dr P Sigwadi 30 May 2012 Introduction Haematuria Positive blood on urine dipstick 5 red blood cells/ microliter of urine Prevalence Gross haematuria ( macroscopic) 0.13 % Microscopic- 1.5% Haematuria +
More informationDr. Rai Muhammad Asghar Head of Paediatric Department BBH Rawalpindi
Dr. Rai Muhammad Asghar Head of Paediatric Department BBH Rawalpindi Acute Post streptococcal Glomerulonephritis Sudden onset of Gross hematuria Edema Hypertension Renal insufficiency Cause of AGN Post
More informationDisorders of the kidney. Urine analysis. Nephrotic and nephritic syndrome.
Disorders of the kidney. Urine analysis. Nephrotic and nephritic syndrome. Azotemia and Urinary Abnormalities Disturbances in urine volume oliguria, anuria, polyuria Abnormalities of urine sediment red
More informationA clinical syndrome, composed mainly of:
Nephritic syndrome We will discuss: 1)Nephritic syndrome: -Acute postinfectious (poststreptococcal) GN -IgA nephropathy -Hereditary nephritis 2)Rapidly progressive GN (RPGN) A clinical syndrome, composed
More informationESRD Dialysis Prevalence - One Year Statistics
Age Group IL Other Total 00-04 12 1 13 05-09 5 2 7 10-14 15 1 16 15-19 55 2 57 20-24 170 10 180 25-29 269 14 283 30-34 381 9 390 35-39 583 14 597 40-44 871 20 891 45-49 1,119 20 1,139 50-54 1,505 35 1,540
More informationGuidelines for the management of a child with haematuria
Guidelines for the management of a child with haematuria Children s Kidney Centre University Hospital of Wales Cardiff CF14 4XW DISCLAIMER: These guidelines were produced in good faith by the author(s)
More informationGlomerular diseases mostly presenting with Nephritic syndrome
Glomerular diseases mostly presenting with Nephritic syndrome 1 The Nephritic Syndrome Pathogenesis: proliferation of the cells in glomeruli & leukocytic infiltrate Injured capillary walls escape of RBCs
More informationGlomerular pathology-2 Nephritic syndrome. Dr. Nisreen Abu Shahin
Glomerular pathology-2 Nephritic syndrome Dr. Nisreen Abu Shahin 1 The Nephritic Syndrome Pathogenesis: inflammation proliferation of the cells in glomeruli & leukocytic infiltrate Injured capillary walls
More informationExamination by dipstick: (Orthotoluidine & organic peroxidase) Hemoglobin free in urine. Hemoglobin from red blood cells in urine.
Examination by dipstick: (Orthotoluidine & organic peroxidase) Hemoglobin free in urine Hemoglobin from red blood cells in urine Myoglobin Normal erythrocyte excretion rate * 0 425.000/12 h. ( mean 65.750
More informationACUTE GLOMERULONEPHRITIS. IAP UG Teaching slides
ACUTE GLOMERULONEPHRITIS 1 Definition Etiology Pathology/pathogenesis Risk factors Clinical Presentation Investigation Differential Diagnosis Management Outcome/Prognosis Indication for Renal Biopsy Summary
More informationHAEMATURIA and it s management. Dr Sanjeev Bandi MBBS.,FRCSI, FRACS(Urology) Consultant Urologist Mackay Urology
HAEMATURIA and it s management Dr Sanjeev Bandi MBBS.,FRCSI, FRACS(Urology) Consultant Urologist Mackay Urology Definition: Haematuria is the presence of red blood cells in the urine. The presence of 10
More informationApproach to Glomerular Diseases: Clinical Presentation Nephrotic Syndrome Nephritis
GLOMERULONEPHRITIDES Vivette D Agati Jai Radhakrishnan Approach to Glomerular Diseases: Clinical Presentation Nephrotic Syndrome Nephritis Heavy Proteinuria Renal failure Low serum Albumin Hypertension
More informationRENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University
RENAL FAILURE IN CHILDREN Dr. Mai Mohamed Elhassan Assistant Professor Jazan University OBJECTIVES By the end of this lecture each student should be able to: Define acute & chronic kidney disease(ckd)
More informationGlomerular pathology in systemic disease
Glomerular pathology in systemic disease Lecture outline Lupus nephritis Diabetic nephropathy Glomerulonephritis Associated with Bacterial Endocarditis and Other Systemic Infections Henoch-Schonlein Purpura
More informationAlterations of Renal and Urinary Tract Function
Alterations of Renal and Urinary Tract Function Chapter 29 Urinary Tract Obstruction Urinary tract obstruction is an interference with the flow of urine at any site along the urinary tract The obstruction
More informationTHE URINARY SYSTEM. The cases we will cover are:
THE URINARY SYSTEM The focus of this week s lab will be pathology of the urinary system. Diseases of the kidney can be broken down into diseases that affect the glomeruli, tubules, interstitium, and blood
More informationCrescentic Glomerulonephritis (RPGN)
Crescentic Glomerulonephritis (RPGN) Background Rapidly progressive glomerulonephritis (RPGN) is defined as any glomerular disease characterized by extensive crescents (usually >50%) as the principal histologic
More informationTHE URINARY SYSTEM. The cases we will cover are:
THE URINARY SYSTEM The focus of this week s lab will be pathology of the urinary system. Diseases of the kidney can be broken down into diseases that affect the glomeruli, tubules, interstitium, and blood
More informationHematuria. Ramzi El-Baroudy (ESPNT)
Hematuria Ramzi El-Baroudy (ESPNT) Hematuria is the presence of RBCs in urine. If the amount of blood in urine is big enough, the urine will, then, look red. Something which is, undoubtedly, terrifying.
More informationRenal Disease. Please refer to the assignment page Three online modules TBLs
Renal Disease Please refer to the assignment page Three online modules TBLs 1 Renal Embryology 2 Lab Tests UA CBC Enzymes Creatinine Creatinine clearance Ammonia Abs C Bx 3 BUN Creatinine Creatinine Clearance
More informationChapter 8: ESRD Among Children, Adolescents, and Young Adults
Chapter 8: ESRD Among Children, Adolescents, and Young Adults The number of children beginning end-stage renal disease (ESRD) care decreased by 6% in 2014, totaling 1,398 (Figure 8.1.a). 9,721 children
More informationRED URINE. 24 th June 2016 Dr Amrit Kaur
RED URINE 24 th June 2016 Dr Amrit Kaur 4 year old male with macroscopic haematuria 5 month h/o intermittent MaH 12 episodes, coca-cola urine Treated for UTIs, urine cultures negative Urine dipstick always
More informationThe University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Nephrology
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Nephrology 1. GOAL: Understand the general pediatrician's role in diagnosis and management of hypertension in children.
More informationMODULE 5: HEMATURIA LEARNING OBJECTIVES DEFINITION. KEY WORDS: Hematuria, Cystoscopy, Urine Cytology, UTI, bladder cancer
MODULE 5: HEMATURIA KEY WORDS: Hematuria, Cystoscopy, Urine Cytology, UTI, bladder cancer LEARNING OBJECTIVES At the end of this clerkship, the learner will be able to: 1. Define microscopic hematuria.
More informationGuideline on the clinical management of Henoch Schonlein Purpura (HSP)
Guideline on the clinical management of Henoch Schonlein Purpura (HSP) Purpose To ensure a standardised approach in the management of children with HSP in southern Derbyshire. Scope The scope of this guideline
More informationDIABETES MELLITUS. Kidney in systemic diseases. Slower the progression: Pathology: Patients with diabetes mellitus are prone to other renal diseases:
Kidney in systemic diseases Dr. Badri Paudel The kidneys may be directly involved in a number of multisystem diseases or secondarily affected by diseases of other organs. Involvement may be at a prerenal,
More informationElevated Serum Creatinine, a simplified approach
Elevated Serum Creatinine, a simplified approach Primary Care Update Creighton University School of Medicine. April 27 th, 2018 Disclosure Slide I have no disclosures and have no conflicts with this presentation.
More informationINTRODUCTION TO RENAL DISEASES
INTRODUCTION TO RENAL DISEASES 1 OUTLINE Introduction &Review of Renal Function Evaluation of renal diseases Urine examination Hematuria Proteinuria 2 FUNCTIONS OF KIDNEY Kidneys maintain the internal
More informationNEPHRITIC SYNDROME. By Dr Mai inbiek
NEPHRITIC SYNDROME By Dr Mai inbiek Nephritic Syndrome The nephritic Syndrome is a clinical complex, usually of acute onset. Is caused by inflammatory lesions of glomeruli. Characterized by; 1) Hematuria
More informationChapter 7: ESRD among Children, Adolescents, and Young Adults
Chapter 7: ESRD among Children, Adolescents, and Young Adults The one-year end-stage renal disease (ESRD) patient mortality among the 0-4 year age group has declined approximately 41.6% over the past decade.
More informationRECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT. J. H. Helderman,MD,FACP,FAST
RECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT J. H. Helderman,MD,FACP,FAST Vanderbilt University Medical Center Professor of Medicine, Pathology and Immunology Medical Director, Vanderbilt Transplant
More informationPediatric GU Dysfunction
Pediatric GU Dysfunction Assessment of pediatric renal function Signs and symptoms Laboratory tests Radiological tests Nursing considerations Psychosocial and developmental considerations GU Disorders
More informationHENOCH SCHÖNLEIN PURPURA (VASCULAR PURPURA, ANAPHYLACTOID PURPURA) IN CHILDREN Single choice tests (SC)
HENOCH HÖNLEIN PURPURA (VAULAR PURPURA, ANAPHYLACTOID PURPURA) IN CHILDREN Single choice tests () 1. Choose the type of bleeding characteristic for the Henoch Schönlein purpura (vascular purpura, anaphylactoid
More informationUSRDS UNITED STATES RENAL DATA SYSTEM
USRDS UNITED STATES RENAL DATA SYSTEM Chapter 8: Pediatric ESRD 1,462 children in the United States began end-stage renal disease (ESRD) care in 2013. 9,921 children were being treated for ESRD on December
More informationPATTERNS OF RENAL INJURY
PATTERNS OF RENAL INJURY Normal glomerulus podocyte Glomerular capillaries electron micrograph THE CLINICAL SYNDROMES 1. The Nephrotic Syndrome 2. The Acute Nephritic Syndrome 3. Rapidly Progressive Glomerulonephritis
More informationNephritic vs. Nephrotic Syndrome
Page 1 of 18 Nephritic vs. Nephrotic Syndrome Terminology: Glomerulus: A network of blood capillaries contained within the cuplike end (Bowman s capsule) of a nephron. Glomerular filtration rate: The rate
More informationDhanalakshmi.R II yr MD Stanley medical college
Dhanalakshmi.R II yr MD Stanley medical college 10 Yr old female child - abdominal pain & vomiting for 1 day. Diffuse in nature, moderate in intensity, not related to food intake & radiates to back. No
More informationNephrotic vs Nephritic syndrome
Nephrotic vs Nephritic syndrome Hooman N.MD IUMS 3 y/o male presents to the ER with fever, abdominal pain, and has had puffy eyes for the past 2 days. 1 What is your diagnosis? 2 Type of Edema Non Pitting
More informationManagement of Acute Glomerulonephritis in Children
1. Background Acute glomerulonephritis develops as a result of abrupt onset of glomerular injury and inflammation that leads to a decline in glomerular filtration rate with sodium and water retention.
More informationMembranoproliferative Glomerulonephritis
Membranoproliferative Glomerulonephritis MPGN is characterizedby alterations in the GBM and mesangium and by proliferation of glomerular cells. 5% to 10% of cases of 1ry nephrotic syndrome in children
More informationGlomerulonephritis. Dr Rodney Itaki Anatomical Pathology Discipline.
Glomerulonephritis Dr Rodney Itaki Anatomical Pathology Discipline. University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology Gross anatomy Ref: Goggle Images Microanatomy
More informationReview Article Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist
International Pediatrics Volume 2012, Article ID 978673, 5 pages doi:10.1155/2012/978673 Review Article Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist
More information29 Glomerular disease: an overview
29 Glomerular : an overview Renal Extra-renal Neurological changes Clinical syndromes pressure Sore throat (streptococcal) Rash Cardiac valve lesions Hemoptysis Asymptomatic or Acute Glomerulonephritis
More informationGlomerular Pathology- 1 Nephrotic Syndrome. Dr. Nisreen Abu Shahin
Glomerular Pathology- 1 Nephrotic Syndrome Dr. Nisreen Abu Shahin The Nephrotic Syndrome a clinical complex resulting from glomerular disease & includes the following: (1) massive proteinuria (3.5 gm /day
More information1. SIGNIFICANCE 2. PREREQUISITES
Topic 13: Differential diagnosis of glomerulonephritis in children. Differential approach to treatment of glomerulonephritis in children. Thematic chapter: Differential diagnosis of the most common diseases
More informationPediatric Nephrology Consult and Referral Guidelines
Pediatric Nephrology Consult and Referral Guidelines Introduction We see children and teens from birth to 21 years. The most common reasons patients are referred to pediatric nephrology services include:
More informationCHAPTER 4. Paediatric Renal Biopsies
2nd Report of the Malaysian Registry of Renal Biopsy 2008 PAEDIATRIC RENAL BIOPSIES CHAPTER 4 Paediatric Renal Biopsies Lee Ming Lee Lim Yam Ngo Lynster Liaw Susan Pee Wan Jazilah Wan Ismail Yap Yok Chin
More informationProteinuria DR. SANJAY PANDEYA MD. FRCPC.
Proteinuria DR. SANJAY PANDEYA MD. FRCPC. Objectives Define normal and abnormal range(s) of proteinuria Evaluation of proteinuria Be aware of complications of proteinuria When to refer and when not to
More informationCHAPTER 2 NEW PATIENTS COMMENCING TREATMENT IN 2007
CHAPTER 2 NEW PATIENTS COMMENCING TREATMENT IN 27 Stephen McDonald Leonie Excell Hannah Dent NEW PATIENTS ANZDATA Registry 28 Report Figure 2.1 Annual Intake of New Patients 23-27 (Number Per Million Population)
More informationYear 2004 Paper one: Questions supplied by Megan
QUESTION 53 Endothelial cell pathology on renal biopsy is most characteristic of which one of the following diagnoses? A. Pre-eclampsia B. Haemolytic uraemic syndrome C. Lupus nephritis D. Immunoglobulin
More informationCHAPTER 3. Secondary Glomerulonephritis
CHAPTER 3 Secondary Glomerulonephritis Rosnawati Yahya Liew Yew Foong 59 3.1: Introduction This chapter covers the main secondary glomerulonephritis that were reported to the MRRB from the year 2005-2010.
More informationLECTURE IN INTERNAL MEDICINE PROPAEDEUTICS 2017/2018
SIGNS AND SYMPTOMS OF URINARY SYSTEM DISEASES (urinary syndrome, nephrotic syndrome, nephritic syndrome, urinary tract obstruction syndrome, hypertensive syndrome) LECTURE IN INTERNAL MEDICINE PROPAEDEUTICS
More informationCHAPTER 3. Secondary Glomerulonephritis
2nd Report of the Malaysian Registry of Renal Biopsy 2008 SECONDARY GLOMERULONEPHRITIS CHAPTER 3 Secondary Glomerulonephritis Rosnawati Yahya Liew Yew Foong 41 SECONDARY GLOMERULONEPHRITIS 2nd Report
More informationDiseases of the Kidney. Janos Vasko
Diseases of the Kidney Janos Vasko Congenital anomalies Glomerular diseases Tubulointerstitial diseases Infections Vascular diseases Stones Tumours POLYCYSTIC KIDNEY DISEASE INFANTILE TYPE ADULT TYPE Autosomal
More informationRadiological Assessment of the Kidney in Patients with Hematuria
March 2005 Radiological Assessment of the Kidney in Patients with Hematuria Jeremy L. McKay, Harvard Medical School Year III Hematuria Signs and Symptoms Microscopic or gross hematuria Abdominal pain Fever
More informationOverview of glomerular diseases
Overview of glomerular diseases *Endothelial cells are fenestrated each fenestra: 70-100nm in diameter Contractile, capable of proliferation, makes ECM & releases mediators *Glomerular basement membrane
More informationChapter 1. Incidence of End Stage Kidney Disease. Contents:
Chapter 1 Incidence of End Stage Kidney Disease Contents: Incidence of End Stage Kidney Disease 1-1 Stock and Flow 1-2 Incident patients 1-3 Incident Rates 1-3 Late Referral 1-7 Co-Morbidities 1-9 Primary
More informationURINANLYSIS. Pre-Lab Guide
URINANLYSIS Pre-Lab Guide NOTE: A very useful Study Guide! This Pre-lab guide takes you through the important concepts that where discussed in the lab videos. There will be some conceptual questions on
More informationNephrotic Syndrome. Department of pediatrics The first affiliated hospital Sun Yat Sen University. Yue Zhihui ( 岳智慧 )
Nephrotic Syndrome Department of pediatrics The first affiliated hospital Sun Yat Sen University Yue Zhihui ( 岳智慧 ) yuezhihui810@yahoo.com.cn Contents Definition Pathophysiology Clinical manifestation
More informationBy Your Sis: Ghada Odeh :)
By Your Sis: Ghada Odeh :) Hx: Chest pain ACS. Hx.: Cough Bronchiectasis. Hx: Epigastric pain Peptic ulcer disease. Hx: Joints Pain SLE. Hx: Hematurea post-strep Glomerulonephritis. Hx: Jaundice Chronic
More informationAcute Kidney Injury (AKI)
(Last Updated: 08/22/2018) Created by: Socco, Samantha Acute Kidney Injury (AKI) Thambi, M. (2017). Acute Kidney Injury. Lecture presented at PHAR 503 Lecture in UIC College of Pharmacy, Chicago. AKI This
More informationSecondary IgA Nephropathy & HSP
Secondary IgA Nephropathy & HSP Anjali Gupta, MD 1/11/11 AKI sec to Hematuria? 65 cases of ARF after an episode of macroscopic hematuria have been reported in the literature in patients with GN. The main
More information(Calcium and Phosphorus are a part of the CKD objectives)
Course Objectives Electrolytes and Water: 1. Differentiate the effects of changes in sodium content from changes in water content 2. Describe how the body compensates for volume loss and volume overload
More informationRENAL HISTOPATHOLOGY
RENAL HISTOPATHOLOGY Peter McCue, M.D. Department of Pathology, Anatomy & Cell Biology Sidney Kimmel Medical College There are no conflicts of interest. 1 Goals and Objectives! Goals Provide introduction
More informationDr Ian Roberts Oxford. Oxford Pathology Course 2010 for FRCPath Illustration-Cellular Pathology. Oxford Radcliffe NHS Trust
Dr Ian Roberts Oxford Oxford Pathology Course 2010 for FRCPath Present the basic diagnostic features of the commonest conditions causing proteinuria & haematuria Highlight diagnostic pitfalls Nephrotic
More informationHenoch Schonlein Purpura
CHILDREN S SERVICES Henoch Schonlein Purpura Definition A vasculitic syndrome of small vessels classically characterised by a purpuric rash, abdominal pain, arthritis, and nephritis. Platelet count and
More informationVasculitis. Edward Dwyer, M.D. Division of Rheumatology. Vasculitis
Edward Dwyer, M.D. Division of Rheumatology VASCULITIS is a primary inflammatory disease process of the vasculature Determinants of the Clinical Manifestations of : Target organ involved Size of vessel
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Study of Laboratory Profile of Acute Post Streptococcal Glomerulonephritis at the Time of Presentation
More informationKeywords: children; diagnosis; etiology; hematuria; proteinuria. Introduction. Methods. Protocol. Eligibility
Diagnosis 2015; 2(4): 211 216 Review Open Access Michelle Clark, Stephen Aronoff and Michael Del Vecchio* Etiologies of asymptomatic microscopic hematuria in children systematic review of 1092 subjects
More informationDefinition : Stages : ( RIFLE vs. AKIN ) Causes and classification : Pre-renal Renal Post- renal Clinical manifestations and Complication Management
AKI Definition : Stages : ( RIFLE vs. AKIN ) Causes and classification : Pre-renal Renal Post- renal Clinical manifestations and Complication Management and indications for RRT Etiology prerenal causes
More informationSCOTTISH REAL BIOPSY REGISTRY: SURVEY OF NATIVE KIDNEY BIOPSY IN SCOTLAND 2015
Scottish Renal Registry Report SECTION N SCOTTISH REAL BIOPSY REGISTRY: SURVEY OF NATIVE KIDNEY BIOPSY IN SCOTLAND All centres in Scotland were able to provide date of birth, sex (except centre), indication
More informationIndex. electron microscopy, 81 immunofluorescence microscopy, 80 light microscopy, 80 Amyloidosis clinical setting, 185 etiology/pathogenesis,
A Acute antibody-mediated rejection (Acute AMR) clinical features, 203 clinicopathologic correlations, 206 pathogenesis, 205 206 204 205 light microscopy, 203 204 Acute cellular rejection (ACR) clinical
More informationCYSTIC DISEASES of THE KIDNEY. Dr. Nisreen Abu Shahin
CYSTIC DISEASES of THE KIDNEY Dr. Nisreen Abu Shahin 1 Types of cysts 1-Simple Cysts 2-Dialysis-associated acquired cysts 3-Autosomal Dominant (Adult) Polycystic Kidney Disease 4-Autosomal Recessive (Childhood)
More informationRenal. Pathology. Kris%ne Kra*s, M.D.
Renal Pathology Kris%ne Kra*s, M.D. Renal Pathology Outline Introductory stuff Glomerular diseases Tubular and inters%%al diseases Diseases involving blood vessels Cys%c diseases Tumors Renal Pathology
More informationLEARNING RESOURCES. YEAR 3 PROBLEM 8 (Nephrotic Syndrome)
PROBLEM 8 (Nephrotic Syndrome) 1. Anatomy: Gross Anatomy of The Kidney Study from: Essential Moore, 5 th Ed., Chapter: 2, Pages: 167-174 or Alhashli slides. 2. Histology: Histology of Glomerulus Study
More informationRaDaR Inclusion and Exclusion Criteria. Diagnosis Inclusion Criteria Exclusion Criteria. Alport Syndrome definite or probable
Alport Syndrome and Type IV collagenopathies APRT Deficiency Alport Syndrome definite or probable Alport carrier definite or probable Thin basement membrane nephropathy APRT Deficiency confirmed Abolished
More informationTHE KIDNEY AND SLE LUPUS NEPHRITIS
THE KIDNEY AND SLE LUPUS NEPHRITIS JACK WATERMAN DO FACOI 2013 NEPHROLOGY SIR RICHARD BRIGHT TERMINOLOGY RENAL INSUFFICIENCY CKD (CHRONIC KIDNEY DISEASE) ESRD (ENDSTAGE RENAL DISEASE) GLOMERULONEPHRITIS
More informationKingdom of Bahrain Arabian Gulf University College of Medicine and Medical Sciences Nephrology and Urology
Kingdom of Bahrain Arabian Gulf University College of Medicine and Medical Sciences Nephrology and Urology - Fluids, electrolytes and dehydration: The most common cause of acute fluid and electrolyte disturbance
More informationUrinary tract pathology Renal syndromes Acute nephritic syndrome syndrome includes oliguria hematuria proteinuria edema hypertension typically occurs
Urinary tract Structure [Figs. 13-1, 13-2] Kidneys (left and right) cortex (glomeruli and tubules) medulla (tubules, loops of Henle, and collecting ducts) calices and pelvis forming the collecting system
More informationGlomerulonephritis (Acute)
Glomerulonephritis (Acute) 1a Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Contact Name and Job Title (author) Directorate & Speciality Date of submission May
More informationRECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT
RECURRENT AND DE NOVO RENAL DISEASES IN THE ALLOGRAFT HISTOPATHOLOGIC DISORDERS AFFECTING THE ALLOGRAFT OTHER THAN REJECTION RECURRENT DISEASE DE NOVO DISEASE TRANSPLANT GLOMERULOPATHY Glomerular Non-glomerular
More informationGlomerular Diseases. Davis Massey, MD, PhD Surgical Pathology Anna Vinnikova, MD Nephrology
Glomerular Diseases Davis Massey, MD, PhD Surgical Pathology Anna Vinnikova, MD Nephrology Classification of Glomerular Diseases http://what-when-how.com/acp-medicine/glomerular-diseases-part-1/ Classification
More informationProteinuria (Protein in the Urine) Basics
Proteinuria (Protein in the Urine) Basics OVERVIEW Proteinuria is the medical term for protein in the urine Urinary protein is detected by urine dipstick analysis, urinary protein: creatinine ratio (UP:C
More informationH(a)ematuria. FX Keeley Consultant Urologist Bristol Urological Institute
H(a)ematuria FX Keeley Consultant Urologist Bristol Urological Institute From Philadelphia to Bristol, England Southmead Hospital, 1916 Southmead Hospital, 2013 Southmead Hospital, 2014 H(a)ematuria Blood
More informationPaediatrics Dr. Bakr Lecture 3 Nephrotic Syndrome
P a g e 1 DEFINITION Paediatrics Dr. Bakr Lecture 3 Nephrotic Syndrome Definition: nephrotic syndrome is a disorder characterized by heavy proteinuria with hypoprpteinimia,hyper lipidemia and edema. It
More informationCHRONIC KIDNEY DISEASE (CKD)
CHRONIC KIDNEY DISEASE (CKD) CKD implies longstanding (more than 3 months), and usually progressive, impairment in renal function. In many instances, no effective means are available to reverse the primary
More informationIntroduction to Clinical Diagnosis Nephrology
Introduction to Clinical Diagnosis Nephrology I. David Weiner, M.D. C. Craig and Audrae Tisher Chair in Nephrology Professor of Medicine and Physiology and Functional Genomics University of Florida College
More informationHenoch-Schonlein Purpura Guidelines
Henoch-Schonlein Purpura Guidelines Henoch-Schonlein purpura (HSP) is the commonest vasculitis of childhood which is selflimiting in majority of cases. Epidemiology: Incidence varies from 10-20 per 100000
More informationHey Doc, there s blood in my urine Evaluation of hematuria. Christian S. Kuhr, MD FACS May 4, 2018
Hey Doc, there s blood in my urine Evaluation of hematuria Christian S. Kuhr, MD FACS May 4, 2018 Objectives Understand the algorithm for hematuria evaluation Know the differential diagnosis for hematuria
More informationHEMORRHAGIC BULLOUS HENOCH- SCHONLEIN PURPURA: A CASE REPORT
HEMORRHAGIC BULLOUS HENOCH- SCHONLEIN PURPURA: A CASE REPORT Nirmala Ponnuthurai, Sabeera Begum, Lee Bang Rom Paediatric Dermatology Unit, Institute of Paediatric, Hospital Kuala Lumpur, Malaysia Abstract
More informationStreptococcus(gram positive coccus) Dr. Hala Al Daghistani
Streptococcus(gram positive coccus) Dr. Hala Al Daghistani Streptococci Facultative anaerobe Gram-positive usually chains (sometimes pairs) Catalase negative Non motile Hemolysins Lancefield Groups (C-carbohydrate
More informationGOOD MORNING. Welcome Applicants! Friday, October 31, (Happy Halloween!)
GOOD MORNING Welcome Applicants! Friday, October 31, 2014 (Happy Halloween!) PREP QUESTION A 14-year-old girl has had 3 days of new, unremitting headache associated with vomiting and awakening from sleep
More informationPrimary causes: Complement dysregulation (50% of non-shiga toxin-producing E. coli ) Secondary causes:
General department INTRODUCTION The hemolytic uremic syndrome (HUS): microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury One of the main causes of acute kidney injury in children
More informationHIV ASSOCIATED NEPHROPATHIES (HIVAN): 30 YEARS LATER
HIV ASSOCIATED NEPHROPATHIES (HIVAN): 30 YEARS LATER Gaston Zilleruelo M.D. Professor of Pediatrics Director of Pediatric Nephrology University of Miami/Holtz Children s Hospital Worldwide 33.2 million
More informationCase Presentation VASCULITIS. Case Presentation. Case Presentation. Vasculitis
Case Presentation VASCULITIS The patient is a 24 year old woman who presented to the emergency room with left-sided weakness. She was confused and complained of a severe headache. She was noted to have
More informationCase Presentation Turki Al-Hussain, MD
Case Presentation Turki Al-Hussain, MD Director, Renal Pathology Chapter Saudi Society of Nephrology & Transplantation Consultant Nephropathologist & Urological Pathologist Department of Pathology & Laboratory
More informationAcute Glomerulonephritis in Southern Iran
Original Article Iran J Pediatr Jun 2008; Vol 18 ( No 2), Pp:143-148 Acute Glomerulonephritis in Southern Iran Ali Derakhshan* 1, MD, Pediatric Nephrologist; Vahid Reza Hekmat 2, Medical Student 1. Shiraz
More informationCHAPTER 3 SECONDARY GLOMERULONEPHRITIS
CHAPTER 3 SECONDARY GLOMERULONEPHRITIS Leong Chong Men Kok Lai Sun Rosnawati Yahya 53 5th Report of the 3.1: Introduction This chapter covers the main secondary glomerulonephritis that were reported to
More informationBiomarkers of renal diseases. By Dr. Gouse Mohiddin Shaik
By Dr. Gouse Mohiddin Shaik Introduction Renal system performs several functions Excretory Waste products like urea, creatinine, drug, toxins clearance Regulatory Water, electrolyte and acid base balance
More information