PROCEDURE Most patients are positioned supine on the lithotripter bed; however, those with stones in anteriorly located kidneys, medial portions of a horseshoe kidney, or transplanted kidneys should be positioned…
Unusual collecting system anatomy, in particular infundibular stenosis, often precludes successful elimination of stone fragments following ESWL and URSLL, again making PCNL the better choice. Finally, congenitally abnormal kidneys, such…
Occasionally, patients may have isolated hematuria (i.e., without proteinuria or renal insufficiency). The differential diagnosis for such patients includes thin basement membrane disease, mild IgA nephropathy, and hereditary nephritis. A…
COMPLICATIONS The main complications of a renal biopsy include bleeding, pain, damage/puncture of surrounding structures (liver, spleen, bowel), and arteriovenous fistula formation. Bleeding is by far the most common complication,…
The patient’s vasculature can be accessed using either a central venous catheter (CVC) or a connection between an artery and vein (fistula or graft). A CVC used for dialysis contains…
ANGIOTENSIN II RECEPTOR BLOCKERS The ARBs are a class of competitive and noncompetitive antagonists of the AT1 angiotensin receptor. These agents are very similar to ACE inhibitors, but they do…
ADVERSE EFFECTS The major adverse effects of potassium-sparing diuretics include: Hyperkalemia Metabolic acidosis. Through the same mechanisms used to reduce K+ secretion, these agents also reduce H+ secretion into the…
ADVERSE EFFECTS The major adverse effects of thiazide diuretics include: Hypokalemia Hyponatremia. By inhibiting solute reabsorption in the distal nephron, thiazides prevent maximal urine dilution. In addition, significant fluid losses…
COMMON AGENTS The major loop diuretics are listed in the plate. INDICATIONS The major indications for loop diuretics include: Peripheral or pulmonary edema Hypertension ADVERSE EFFECTS The major adverse effects…
ADVERSE EFFECTS The major adverse effects of CAIs include: Metabolic acidosis Nephrolithiasis, owing to urine alkalinization Increased serum ammonia concentration, secondary to impaired renal excretion, which may cause encephalopathy in…
