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Renal Disease (Clinical Signs of Dysfunction (Oedema, fluid retention…
Renal Disease
Normal Function
Synthesise Vit D, EPO, renin, prostaglandins
(hence anaemia, ostoeporosis in renal disease)
Target organ for aldosterone, PTH
Excretion of metabolites, drugs, hormones
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Staging (GFR)
Stage 3: Moderate ↓ GFR (30-59mL/min)
- Anaemia 7%
- HTN 55%
- DM 20%
- Hyperparathyroidism >50%
- 5yr mortality rate 24%
Stage 4: Severe ↓ GFR (15-29mL/min)
- Anaemia 29%
- HTN >75%
- DM 30%
- Hyperparathyroidism >50%
- 5yr mortality rate 46%
Stage 2: Kidney damage with normal or mild ↓ GFR (60-89mL/min)
- Anaemia 4%
- HTN 40%
- DM 13%
Stage 5: Kidney failure (ESRF) (GFR <15 or dialysis)
- Anaemia 69%
- HTN >75%
- DM 40%
- Hyperparathyroidism >50%
- 5yr mortality rate >50%
Stage 1: Kidney damage with normal or ↑ GFR (≥90mL/min)
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Glomerular Filtration Rate (GFR) is the single most predictive test of renal function
Creatinine, urea, and electrolyte levels may also be measured. Note that serum creatinine levels vary with muscle mass.
Urinalysis may also be used to detect levels of sugar, proteins, creatinine etc. in the urine.