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19 Cards in this Set
- Front
- Back
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prerenal ddx
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true volume depletion
hypotension edematous states renal ischemA |
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renal ddx
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acute tubular necrosis
acute interstitial nephritis glomerulas dz vasuclitis |
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postrenal
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obstructive uropathy
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urinanalysis in pre-renal
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low sodium (bc kidney is holding onto it) and fairly clean (no proteinuria, hematuria, etc)
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when to calculate FeNa
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oliguria < 400-500ml or anuria <100 ml
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FeNa =
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U/P sodium x U/P creatinine x 100 = Una x Pcr x 100 / Pna x Ucr
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when might FeNa not be accurate
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when the pt is on a diuretic; use FEurea instead (Uurea x Pcr) x 100 / Purea x Ucr
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red dipstick w/o rbc on analysis
(lots of blood by dipstick, no blood on analysis) |
rhabdomyolysis (loss of myoglobin) or HUS (loss of hemoglobin)
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renal tubular cells and rtc casts/muddy
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ATN
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white cell casts
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cystitis, pyelonephritis, AIN
if negative urine culture = allergic interstitial nephritis (order hansen stain for eosinophils) |
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rbc casts
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trauma, foley, stones, bladder CA, coag., infection, GN
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dysmorphic rbc cast/protein
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GN, vasculitis
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protein/lipiduria (no cells)
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glomerular
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maltese cross
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lipid droplets; indicates lipiduria
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bladder neck obstruction ddx
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BPH or malignancy, neuropathy, anticholinergic medication (anticholinergic)
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ureteral obstruction ddx
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stones, clots, puts, retroperitoneal fibrosis, lymphadenopathy, malignancy
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post-renal ARF diagnosis
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ultrasound; might miss "encased" kidneys such as severe retroperitoneal fibrosis
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Tx for postrenal ARF
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foley catheter to relieve backed up urine
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playing odds for acute renal failure
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ATN 2nd to ischemia, sepsis, hypotension, nephrotoxins (myoglobin, hemoglobin, benz jones proteins,
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