Nephrology is an important speciality; patients with acute or chronic kidney failure are encountered in every medical and surgical speciality, as well as in general practice. On most general medical rotations and on most surgical wards there are patients with renal problems. Renal medicine is taught on rotation during degree courses, and Foundation training programmes frequently include attachments in nephrology, urology, and renal transplantation. Nephrology: Clinical Cases Uncovered contains clinical presentations with real-life patient cases and outcomes as seen on the wards and in exams, and leads students through a practical approach to diagnosis and management of kidney disease. Following a question-answer approach, including self-assessment material and a ‘refresher’ section on the basic science of this clinical area, Nephrology: Clinical Cases Uncovered features investigations and the treatment options available for patients with renal disease, including those requiring renal replacement therapy with dialysis and transplantation. Difficult concepts are clarified, using simple diagrams to explain the link between pathology and clinical presentation.
Nephrology: Clinical Cases Uncovered is ideal for medical students, junior doctors on the Foundation Programme, GP trainees, and specialist nurses and nurse practitioners. This book is also a useful refresher for nephrology trainees at the beginning of their specialist training programme.
Preface vii
Acknowledgements ix
How to Use This Book x
List of Abbreviations xi
Normal range for investigations xiv
Part 1 Basics 1
Basic science 1
Approach to the patient 8
Clinical overview 13
Part 2 Cases 30
Patients with Acute Renal Failure
Case 1 An 84-year-old man with reduced urine output 30
Case 2 A 74-year-old man with acute renal failure 37
Case 3 A 64-year-old man with back pain and polydipsia 45
Case 4 A 20-year-old woman with facial swelling and coke-coloured urine 51
Case 5 A 68-year-old man with hearing loss, fatigue and arthralgia 56
Case 6 A 19-year-old man with macroscopic haematuria 62
Case 7 A 27-year-old woman with a rash and renal impairment 68
Case 8 A 26-year-old man with haemoptysis and oliguria 72
Case 9 A 25-year-old woman presents with rash and joint pain 78
Case 10 An 18-year-old girl with lethargy and headache 86
Patients with Nephrotic Syndrome
Case 11 A 56-year-old man with ankle swelling 93
Case 12 An 80-year-old man with abdominal discomfort and ankle swelling 98
Case 13 A 23-year-old obese woman with ankle swelling 106
Case 14 A 15-year-old girl with facial swelling and frothy urine 113
Patients with Hypertension
Case 15 A 50-year-old woman with hypertension 117
Case 16 A 60-year-old male smoker with hypertension and renal impairment 123
Patients with Urine Dipstick Abnormalities
Case 17 A 25-year-old woman with dysuria and urine dipstick abnormalities 128
Case 18 A 40-year-old ex-intravenous drug user with protein and blood on urine dipstick 133
Case 19 A 35-year-old man with macroscopic haematuria 138
Case 20 An 82-year-old woman with dark urine 143
Acid–Base wnd Electrolyte Problems
Case 21 A 28-year-old type I diabetic man with abdominal pain and vomiting 148
Case 22 A 22-year-old man with weakness and lethargy 154
Case 23 A 58-year-old type II diabetic with confusion and hyponatraemia 159
Patients with Chronic Kidney Disease/End-Stage Renal Failure
Case 24 A 49-year-old man with headache and malaise 163
Case 25 A 23-year-old man with shortness of breath 169
Case 26 A 34-year-old man on haemodialysis 176
Case 27 A 54-year-old man with end-stage renal failure 181
Case 28 A 50-year-old man on peritoneal dialysis with abdominal pain 187
Renal Transplantation
Case 29 A 49-year-old man with chronic kidney disease 193
Case 30 A 38-year-old man with a rise in creatinine 2 weeks post renal transplant 201
Case 31 A 45-year-old man with a renal transplant and fever 210
Part 3 Self-assessment 215
MCQs 215
EMQs 220
SAQs 227
Answers 229
Index of cases by diagnosis 246
Index 247
Height:246
Width:191
Spine:14
Weight:653.00