Medical Renal Diseases

Medical renal diseases involve the parenchyma of the kidney, however symptoms and signs are common to both medical and surgical diseases of the kidneys and they include:

  • Hematuria
  • Proteinuria
  • Oliguria (less urine output)
  • Polyuria (more urine output)
  • Pain
  • Renal insufficiency
  • Acidosis
  • Anemia
  • Hypertension
  • Electrolyte imbalance
  • Pyuria

However, these are few unique features in the medical history. Physical examination or laboratory studies that help us distinguish between medical and surgical diseases of kidneys are:

  • Family history of nephritis
  • History of infections, step throat, exposure of toxic agents, nephrotoxic drugs, diabetes, hypertension and autoimmune disease.
  • Signs of edema, hypertension
  • Proteinuria, red blood cells casts, fatty casts, in urinalysis
  • Renal biopsy for light and electron microscopy

Post Streptococcal Glomerulonephritis

  • History of streptococcal throat infection
  • Low grade fever, malaise, headache, anorexia
  • Mild hypertension, oedema
  • Proteinuria, hematuria, RBC casts, hyaline casts and granular casts
  • Elevated antistreptolysin O titer
  • Hypercomplementemia
  • Affects both kidneys
  • Recovery from acute stage is complete
  • Progressive disease may destroy renal tissues
  • Acute glomerulonephritis is most common in children
  • Group A B-hemolytic streptococci
  • Impetigo

Ig A Nephropathy

  • More common in males
  • Gross or microscopic hematuria
  • No satisfactory therapy

Antiglomerular Basement Membrane Nephritis (Goodpasture Syndrome)

  • History of hemoptysis
  • Malaise, anorexia, headache
  • Gross or microscopic hematuria
  • High dose corticosteroids with immunosuppressive therapy

Nephrotic Syndrome

Clnical features:

  • Proteinuria
  • Oedema
  • Hypoalbuminemia
  • Hyperlipidemia
  • Renal biopsy is essential to make the diagnosis

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