Patients with edema do not necessarily have nephrotic syndrome, since other diseases—notably congestive heart failure and cirrhosis—can present in this fashion. The diagnosis of nephrotic syndrome is suggested, however, when…
Titratable Acids. Urine contains several weak acids that serve as urinary buffers. These buffers are also called “titratable acids” because their concentration can be determined based on how much NaOH…
Because patients with MCD tend to have very severe proteinuria, clinicians must be alert for the presence of related complications. As in all cases of nephrotic syndrome, patients are at…
Patients with nephrotic syndrome are at increased risk for lower extremity, pulmonary, and renal vein thromboses (see Plate 4-35) because of urinary losses of anticoagulant proteins, such as antithrombin and…
PREVENTION The most effective prevention strategy is to maintain euvolemia in hospitalized patients and to avoid excessive exposure to nephrotoxic agents, especially in patients with preexisting renal disease. In situations…
The first manifestation of disease is typically a sharp increase in serum creatinine concentration on routine laboratory examination. Recent exposure to a known nephrotoxin strongly suggests the diagnosis of ATN,…
Once postrenal AKI is suspected, the patient should undergo further evaluation with radiographic imaging to further characterize the obstruction. MANAGEMENT The specific management of these various etiologies is discussed later…
Patients with prerenal AKI may exhibit other signs of volume depletion, such as tachycardia, orthostatic hypotension, and dry mucous membranes. In addition, prerenal AKI can be distinguished from other causes…
Other drugs that may cause diabetes insipidus include demeclocycline, amphotericin B, and orlistat. The mechanisms are diverse and not completely understood. V2 receptor antagonists, such as tolvaptan, may cause transient…
TREATMENT All potentially modifiable causes of NDI should be reversed. Lithium, for example, should be discontinued, and hypokalemia or hypercalcemia should be corrected. These measures may lead to complete recovery…
