…resistance Thyroid disease Kidney disease Excessive alcohol consumption Diets high in carbohydrate or fat Glucocorticoids Beta blockers Oestrogen therapy Some antiretroviral therapies Post transplant medications…

Njurmedicin Lathundar Acute management on call Acute kidney injury, AKI, is a syndrome of rapidly deteriorating renal function. Management is governed not by the creatinine…

Cardiology Nephrology Definition and pathophysiology Chronic kidney disease (CKD) is defined by abnormalities of renal structure or function that persist for more than 3 months…

Cardiology Nephrology Definition and terminology Contrast associated acute kidney injury is an acute deterioration in renal function occurring after exposure to iodinated contrast media, particularly…

…Staging of chronic kidney disease Stage eGFR Description : : : G1 ≥ 90 Normal or high G2 60–89 Mildly reduced G3a 45–59 Mildly to moderately reduced…

…normal potassium the urine cannot be alkalinised. The kidney then chooses to excrete hydrogen ions instead of potassium, and the urine stays acidic however much…

…Renal Disease (MDRD) equation is a widely used tool for estimating the glomerular filtration rate (eGFR), which assesses kidney function. Developed from the MDRD study…

…action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing kidney perfusion. Effects Dopamine 1 receptor agonists lower systemic blood pressure…

…context of chronic kidney disease, ACE inhibitors slow the rate of decline of kidney function in a manner that extends beyond the reduction of systemic…

…nephrology early in anuria, in a dialysis patient, in severe acute kidney injury, in treatment failure or in ongoing massive potassium release. In cardiac arrest…

…has not been shown to improve the prognosis and can cause hypotension, acute kidney injury, myocardial ischaemia or cerebral hypoperfusion. Pain, anxiety, urinary retention, hypoxia…

…to moderate heart failure, kidney or liver disease, especially when combined with diuretics (risk of fluid retention and impaired kidney function). Patients with bronchial asthma…

…reduced hemoglobin/hematocrit, bleeding history, insufficient kidney function, and treatment with antiplatelet agents. Research indicates that the ORBIT score may offer better discrimination and calibration…

…where diabetes specific risk assessment or risk categorization is applicable Moderate or severe chronic kidney disease (CKD) Hypertension mediated organ damage (HMOD) Probable or definite…

…arrhythmias, thyroid disease, iron deficiency and anaemia, kidney dysfunction, sleep disordered breathing, cancer related disease and cardiac amyloidosis among the relevant clinical settings or comorbidities…

…stroke, coronary perforation, haemodynamic collapse, acute kidney injury, and death. The risk profile differs between diagnostic angiography and PCI, and is strongly influenced by the…

…tools for cardiovascular risk reduction, offering profound benefits in major adverse cardiovascular events (MACE), heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD…

…collateral circulation. A first or anterior infarction. Single vessel disease without collateral support. Chronic kidney disease, particularly in relation to VSR. Large infarction, especially for…

…aldosterone responsive genes. Although the kidney is a major target—where MR activation promotes sodium transport—MRs are also present in cardiac myocytes, vascular smooth…

…can be defined. The central physiological contributors include excess salt intake and salt and water retention, particularly when kidney function is impaired. Inadequate adherence to…

…including: Cardiac causes Systemic causes Heart failure Sepsis Myocarditis Chronic kidney disease Cardiomyopathy Stroke or subarachnoid haemorrhage Takotsubo syndrome Pulmonary embolism Recent coronary revascularization Infiltrative…

…even when cardiovascular event reduction is not demonstrated in every intervention study. Cardiovascular Risk Assessment Screening for cardiovascular and kidney disease All patients with diabetes…

…A normal creatinine can conceal markedly reduced renal function. Acute kidney injury changes clearance from day to day. Reassess the dose daily and follow creatinine…

…if tolerated 70–79 Diabetes 120–130 70–79 Chronic kidney disease 130–139 70–79 Avoid a systolic pressure < 120 mmHg and a…

…suspension in water. A glass of water between doses of charcoal makes the drink more tolerable. A kidney dish, a beaker or a straw, tissues…

…sweating and pallor that may suggest phaeochromocytoma. Systemic sclerosis, kidney disease, autoimmune disease or previous thrombotic microangiopathy. Antidepressants can affect the blood pressure in several…

…and change to an infusion or injections Drugs for type 2 diabetes in inpatients Agent The acutely ill inpatient : : Metformin Stop in acute kidney injury…

…irrigation catheter, or an electric ear irrigator with pressure limitation, body temperature water or saline ( 36–37 °C ), a kidney dish, a towel, suction. Manual…

…cold or mottled skin Metabolism and perfusion A lactate above 2 mmol/L, metabolic acidosis or a rising lactate Kidney A rise in creatinine, oliguria…

…with ticagrelor. The mechanism is unclear. Kidney function should be monitored according to clinical practice. Special attention should be given to patients ≥ 75 years, those…

…coronary disease. It is also the most prevalent antecedent of heart failure—particularly heart failure with preserved ejection fraction—and chronic kidney disease. After approximately…

…concentric remodelling, reduced longitudinal strain and heart failure with preserved ejection fraction are more frequent in women. Diabetes confers greater cardiovascular risk in women than…

…improve angina and quality of life, but randomized trials have not demonstrated reductions in mortality or myocardial infarction rates. Clinical presentation and symptoms The clinical…

…raised natriuretic peptides. HF with mildly reduced ejection fraction (HFmrEF) is defined by symptoms and/or signs of HF with LVEF 41–49%. In this…

…initiate self perpetuating metabolic and inflammatory pathways that injure the vasculature, heart and kidneys. Advanced glycation end products activate inflammatory and profibrotic signalling through their…

…cardiovascular risk T2DM with chronic kidney disease Heart failure with reduced ejection fraction (HFrEF), with or without diabetes Heart failure across the ejection fraction spectrum…

Cardiology Definition and terminology Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome characterized by the cardinal symptoms and signs of heart…

…vasodilatation. D1 and D2 (dopamine receptors): activation of D1 and D2 in the kidneys and the splanchnic vascular bed leads to renal and mesenteric vasodilatation…

…60 to 65 mmHg is generally considered the minimum threshold necessary to ensure sufficient blood flow to vital organs such as the brain and kidneys…

…retina, heart, aorta, kidneys, or other vascular beds. Malignant hypertension represents an extreme form in which acute microvascular injury occurs, classically involving fibrinoid necrosis of…

…renal sodium and water excretion, and reduction of cardiac fibrosis through activation of the natriuretic peptide A receptor. NT proBNP is an inactive cleavage product…

…evaluation and ongoing management of patients on sotalol. Because the drug is excreted unchanged primarily by the kidneys, creatinine clearance must be assessed prior to…