Hello guys!
In this post I am going to list down the Indications for dialysis in patients of Chronic Renal Failure.
Absolute Indications :
1. Volume overload not responding to medication.
2. Refractory hypertension.
3. Hyperkalemia unresponsive to medications.
4. Severe metabolic acidosis unresponsive to medications.
5. Uremic pericarditis
6. Neurological signs and symptoms of Uremia.
7. Plasma creatinine more than 1060 umol/l or BUN more than 36 mmol/l
Relative Indications :
1. Anorexia
2. Severe anemia unresponsive to erythropoietin.
3. Persistent severe pruritus.
4. Restless legs syndrome.
That's all.
Thank you
MD Mobarak Hussain (Maahii)
Hello!
Here's a post on the association between renal stones and pH of urine.
Which stones form in acidic urine?
Mnemonic: It's pretty simple, stones which have "weak acids" as a component.
Uric ACID
Calcium oxalate (Oxalic ACID)
Cysteine (Which is an Amino ACID)
PS: This is just a mnemonic.
Which stones form in alkaline urine?
Calcium Phosphate
Magnesium Ammonium Phosphate
That's all!
-IkaN
Which of the following electrolysi abnormalities will you see in tumor lysis syndrome?
Answer either high, normal or low for each of these - calcium, phosphate, potassium, uric acid.
Answers:
Labs in tumor lysis syndrome -
Hypocalcemia
Hyperuricemia
Hyperphosphatemia
Hyperkalemia
Why?
When cancer cells lyse, they release potassium, phosphorus, and nucleic acids, which are metabolized into hypoxanthine, then xanthine, and finally uric acid.
This leads to:
Hyperkalemia can cause serious — and occasionally fatal — dysrhythmias.
Hyperphosphatemia can cause secondary hypocalcemia, leading to neuromuscular irritability (tetany), dysrhythmia, and seizure, and can also precipitate as calcium phosphate crystals in various organs (e.g., the kidneys, where these crystals can cause acute kidney injury).
Uric acid can induce acute kidney injury not only by intrarenal crystallization but also by crystal-independent mechanisms, such as renal vaso-constriction, impaired autoregulation, decreased renal blood flow, oxidation, and inflammation.
Crystal-induced tissue injury occurs in the tumor lysis syndrome when calcium phosphate, uric acid, and xanthine precipitate in renal tubules and cause inflammation and obstruction.
That's all!
-IkaN
The common causes of greenish discolouration of urine are :
(1) Phenol containing compounds: Promethazine, Propofol, Thymol,
(2) Dyes: Indigo-blue, Indigo carmine, Carbolic acid, Flavin derivatives,
(3 Biliverdin (in cases of long standing obstructive jaundice),
(4) Amitryptyline (anti-depressant),
(5) Pseudomonas infection,
(6) Cemetidine,
(7) Indomethacin,
(8) Methylene blue (bluish )
Lowe Syndrome (Oculocerebrorenal dystrophy) mnemonic
Think of Lowe = Love and it'll make sense.
Lowe makes you blind (cataracts, glaucoma)
Lowe makes you HAPpy (High Alkaline Phosphatase along with normal calcium, low phosphate)
Lowe messes with your head (intellectual disability)
LoveR - Renal defects (proximal tubular acidosis, aminoaciduria, and low-molecular-weight proteinuria)
Lowes syndrome is a cause of Fanconi syndrome.
That's all!
-IkaN
Hi everyone. Here's a short summary of the causes for Renal cell carcinoma !
Renal Cell Carcinoma ( or RCC) is a common tumor of the kidneys and is essentially an Adenocarcinoma.
It's quite often called as the 'great mimic' as it is relatively hard to diagnose.
Here's the list of causes of this tumor.
Remember :
CCCC or C4
C = Cigarette smoking and Tobacco usage.
C = Chronic Kidney Disease / Cystic (Acquired) Disease of kidneys.
C = Cadmium, Asbestos and other occupational Exposures.
C = Cancer Syndromes.
Important Cancer Syndromes =
- Von Hippel Lindau Syndrome :
3p mutation in VHL Gene which is a tumor suppressor --> Tumors seen include Cerebellar and Retinal Hemangioblastomas , Pheochromocytoma, RCC (Clear type) and various other Cystic tumors.
- Tuberous Sclerosis
- Birt Hogg Dube Syndrome : Associated with various weird skin changes and chromophobe type RCC.
Skin changes include --> Tumors of Hair disc (Tricho-discoma) , Tumors of Hair follicle - Fibrofolliculoma and Acrochordons ( skin tags).
- Hereditary Papillary Cancer : Associated with MET Gene mutations
- Hereditary Leiomyomatosis with RCC : Associated with multiple Fibroids in the uterus.
That's all for today!
Hope this helped.
Happy Studying !
And, as always , Stay awesome !
~ A.P.Burkholderia
Hey guys, there are multiple causes of acute kidney injury in a cancer patient, namely sepsis, metastasis, tumor lysis syndrome, etc. But there is another reason which we often overlook, which is drug-induced.
1. Thrombotic microangiopathy: Associated with agents targeting vascular endothelial growth factor(VEGF), eg., Ranibizumab, Bevacizumab. These drugs also block the angiogenesis in the glomerular vasculature, such that the injured endothelium isn't replaced, leading to multiple foci of platelet aggregations just like in TTP and HUS.
2. Focal segmental glomerulosclerosis: Associated with tyrosine kinase inhibitors are the most common and are frequently associated with acute kidney injury.
3. Acute Interstitial Nephritis:
The checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab activate host T cells to enhance tumor killing by preventing tumor ligand binding to cytotoxic T-lymphocyte antigen 4 and programmed death 1 receptors, which deactivate T cells. However, this effect causes loss of self-tolerance (and perhaps tolerance to other drugs), leading to various forms of autoimmune injury, including acute interstitial nephritis, which is associated with moderate-to-advanced-stage acute kidney injury.
That's all!
-VM
Well, urine is largely water which *can* be considered as transparent. That's why, uric acid stones don't show up on X-rays.
Struvite or triple phosphate stones have Proteus has the causative factor. Remember p for p
That's all!
-Sushrut Dongargaonkar
