Symptoms - Renal Disorders

• What are the phases of AKI?

  • Initiation (onset) phase: can last for hours to days
  • Oliguric phase: (can last up to 2 weeks or more)
  • Diuretic phase: (can last 1 – 3 weeks)
  • Recovery phase: (up to 12 mo)
• What are the clinical manifestations presented in acute kidney injury?

  • Urine vol decreases (except diuretic phase)​
  • Fluid overload
  • Hyperkalemia
  • Decreased Na
  • Decreased calcium/Increased Phosphorus
  • Metabolic acidosis
  • Anemia ​
  • Increased BUN/Creatinine 
• What are the symptoms of fluid overload that is present within AKI?

  Edema, weight gain, distended neck veins, HTN, pulmonary edema
• How do the symptoms of increased BUN/Creatinine present in the patient with AKI?

  impaired clearance, dehydration, increased protein breakdown
• What should you consider if gross or microscopic hematuria with hypotension & tachycardia appear on a patient with renal trauma?

  Vascular injury = hemorrhage!
• What are the symptoms of acute glomerulonephritis?

  • Cola-colored urine = hematuria; proteinuria, abdominal or flank pain, oliguria*, HTN, headache​
  •  Sx of fluid overload [generalized edema, periorbital edema, pulmonary edema, dyspnea, HTN,] because of Na and water retention 
• What are the symptoms of polycystic kidney disease?

  HTN (1st sign)

  • flank/lumbar dull ache pain [progresses to sharp as cysts rupture]
  • pyuria, hematuria
  • kidney stones, UTI
  • constipation
  • palpable kidney mass
  • signs of kidney failure
• What are the symptoms of renal cancer?

  Initially asymptomatic...​

  • Classic Triad
  • [Flank mass, Flank pain, Hematuria], 
  • weight loss, HTN, fever, anemia 
• What are the symptoms of renal trauma?

  • *Hematuria [gross or microscopic], 
  • colicky flank pain,
  • palpable mass/swelling in affected flank area​
  • Grey Turner's Sign: bruising over flank d/t retro-peritoneal bleeding​
  • Cullen's sign: bruising around the umbilicus ​
  • Sx of shock w/ severe bleed 
• What are the symptoms of chronic kidney disease?

  Devastating effect of every body system...​

  • Na & Fluid imbalances [HTN, HF, pulmonary edema],
  • Altered K excretion [lethal arrhythmias]
  • Impaired metabolic waste elimination
  • [GI – N/V, anorexia]
  • [Neuro – headache, lethargy, fatigue, confusion],
  • Altered Ca & P lvls [bone breakdown, osteodystrophy]
  • Dec acid clearance & bicarb production [metabolic acidosis]
  • Endocrine & Reproductive Dysfunction [infertility, amenorrhea, hyperparathyroidism & thyroid abnormalities]
  • Decreased erythropoietin production [anemia] 
• What kind of renal dysfunction causes EKG abnormalities?

  worsening Hyperkalemia
• What do the EKG abnormalities progress to in the state of hyperkalemia in AKI?

  Normal --> Peaked T waves --> Widened QRS --> absent P waves