Renal syndrome

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  • Asymptomatic urinary abnormalities:
    • Asymptomatic hematuria/proteinuria, pyuria, casts, crystals
  • Acute nephritic syndrome (aGN):
    • Hematuria (± RBC casts), (mild to moderate) proteinuria, pyuria, azotemia (GFR ↓) in days, HT, edema, oliguria, sometimes causes RPGN
  • Rapidly progressive GN (RPGN):
    • aGN with azotemia in weeks~3 months (subacute renal failure), oliguria, HT, edema, hematuria, proteinuria, pyuria, casts
    • Usually crescentic GN (>50% glomeruli with crescents)
  • Acute renal failure (ARF) or acute kidney injury (AKI):
    • Azotemia in days; oliguric or non-oliguric, hypertension, edema
  • Basement membrane syndrome
    • Hematuria, proteinuria, renal failure
  • (Chronic GN: a poorly defined entity)
    • Hematuria/proteinuria ± HT >3 months
  • Nephrotic syndrome (NS):
    • Proteinuria >3.5 g/1.73 m2/day; hypoalbuminemia, hyperlipidemia (esp. hypercholesterolemia), casts, lipiduria, edema
  • Chronic kidney disease (CKD):
    • Stage 1-5 (eGFR < 60 mL/min/1.73 m2 or proteinuria), > 3 months.
  • Chronic renal failure (CRF):
    • Azotemia>3 months; urine broad waxy casts (“renal failure casts”), uremic symptoms, proteinuria, hematuria, urine casts, nocturia, HT, edema, acid-base/electrolyte dis.
  • Uremia (acute or chronic): Azotemia + uremic syndrome
  • ESRD (end-stage renal disease): CKD stage 5D or chronic dialysis
  • Renal tubule defects:
    • Electrolyte and acid-base dis., polyuria, nocturia, renal transport defects, renal calcification or stone, normal-sized kidneys; hematuria, proteinuria (usually <1 g/24 hours), nocturia, bone pain, rickets
  • Glomerular vascular syndrome: HT, proteinuria, hematuria
  • Pulmonary-renal syndrome:
    • Catastrophic hemoptysis (lung infiltrate) + GN (esp. RPGN)
  • Urinary tract infection (UTI):
    • Fever, dysuria, frequency, urgency, suprapubic pain, flank pain, pyuria (WBC ≥ 2-5/HPF of mid-stream urine), bacteriuria (≥ 102 single flora colonies/mL if symptomatic or catheterized; ≥ 105 single flora colonies/mL x 1 [men]~2 [women] if asymptomatic), bacteria in unspun urine, WBC casts
    • 1. Uncomplicated, 2. Complicated
    • 1. Cystitis, 2. prostatitis, 3. pyelonephritis 4. renal abscess, 5. catheter-related UTI, 6. asymptomatic bacteriuria (do not treat unless pregnant), (7. urethritis)
  • Urinary tract obstruction: Oliguria, nocturia, slowing of micturition, BPH, hydronephrosis, flank pain, full bladder ppost-voiding; hematuria, pyuria, enuresis, dysuria, HT, urinary retention,, azotemia, AKI, CKD
  • Cardiorenal syndrome: type 1 (acute), type 2 (chronic), type 3 (acute renocardiac), type 4 (chronic renocardiac), type 5 (systemic dis.)
取自"http://wiki.kmu.edu.tw/index.php/Renal_syndrome"