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Correlation between spot UPro/Cr ratio and 24 hour urine? --> moderate accuracy (R 0.8)
- Still very useful for clinical practice, limitation is mostly for research purposes (UPro < 3g is often treatment goal)
Posted 11/29/16 09:09:54 AM by Matthew Cummings
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Renal US for the assessment of chronic kidney disease chronicity?
- US can help assess for chronicity if kidneys are SMALL in size (echogenicity is less reliable)
Posted 11/29/16 09:11:41 AM by Matthew Cummings
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Concern for plasma cell disorder/amyloidosis and associated renal disease?
- Must send serum free light chains (SFLC) -- can detect the low levels of FLCs (may be below threshold detected by SPEP/UPEP) AND SFLC can detect changes in kappa/lambda ratio (excess plasma cell clone)
Posted 11/29/16 09:16:43 AM by Matthew Cummings
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Nephrotic syndrome in African-American population:
- FSGS (#1 in African Americans -- also think FSGS due to HIV, viral hepatitis)
- Membranous (also think underlying malignancy)
- MCD (think Hodgkin's disease)
- Amyloidosis (primary or secondary)
- DM (usually after 5-10 yrs of poor control)
Posted 11/29/16 09:21:07 AM by Matthew Cummings
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Minimal change disease + interstitial nephritis? Think NSAIDS
Posted 11/29/16 09:21:25 AM by Matthew Cummings
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Nephrotic syndrome and edema formation
- Likely NOT due to oncotic pressure imbalance -- rat model with undetectable albumin NOT edematous
- Loss of glomerular integrity --> glomerular filtrate/protein --> activates sodium channel --> sodium/fluid retention
Posted 11/29/16 09:28:31 AM by Matthew Cummings
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Nephrotic syndrome and risk of VTE
- Highest in membranous -- loss of anti-thrombin
- Hypoalbuminemia = most significant predictor of thrombotic risk (especially <2 g/dL).
- Low index of suspicion for renal vein thrombosis/PE
Posted 11/29/16 09:30:56 AM by Matthew Cummings
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For further reading...
Posted 11/29/16 09:35:47 AM by Matthew Cummings