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