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💧 RENAL SYSTEM CLINICAL CHEAT SHEET
💧 1. RAAS Memory Tip (VASoA)
Renin → Ang I → ACE → Ang II → Effects (VASoA): V: Vasoconstriction A: Aldosterone ↑ (Na ⁺+ water retention) S: Sympathetic activation ↑ o: Kidney water & Na ⁺retention A: ADH release ↑
💧 2. AKI Types & Key Features
Feature Prerenal AKI Intrarenal AKI Postrenal AKI Problem ↓ Perfusion Direct kidney damage Obstruction Causes Hypovolemia, HF, sepsis, NSAIDs ATN, AIN, toxins, GN, infections Stones, BPH, tumors Urine Concentrated, ↓ Na⁺ Dilute, ↑ Na⁺ Variable Reversible? Yes (restore perfusion) No (cell damage) Often yes (relieve obstruction) Progression Risk → ATN if untreated → CKD → Intrarenal AKI
⚡ NSAID Injuries
Prerenal: ↓ Prostaglandins → afferent constriction → ↓ GFR Intrinsic: o ATN: Ischemic tubular damage o AIN: Drug allergy (fever, rash, eosinophilia)
💧 3. Labs & Diagnostics
↑ BUN/Creatinine → ↓ GFR Electrolytes: ↑ K , ↑ phosphate, ↓ Ca²⁺ ⁺ ABG: Metabolic acidosis
UA: Proteinuria, casts, hematuria Imaging: Renal US (obstruction), CT (stones), biopsy (if unclear)
💧 4. Clinical Assessment
History & Physical: Check for dehydration, drug use (NSAIDs, ACEI), diabetes, HTN, HF Signs: Orthostatic hypotension, edema, HTN, infection 💡 Tip: “Anything that starves, stresses, or poisons the kidneys.”
💧 5. Treatment Overview
Type Main Treatment Prerenal Fluids, correct perfusion, monitor overload Intrarenal Remove toxin, stop drug, supportive therapy Postrenal Relieve obstruction, stent/catheter, surgery
💧 CHRONIC KIDNEY DISEASE (CKD)
💧 Causes
HTN, DM, pyelonephritis, GN, BPH, CAD, toxins, autoimmune diseases
💧 Pathophysiology
↓ Nephron function → ↓ GFR → ↑ Waste (uremia) → Fluid & electrolyte imbalance → Hormonal dysfunction (EPO, renin, vitamin D)
💧 Clinical Manifestations
System Key Findings Neuro Confusion, delirium, uremic encephalopathy Cardiac HTN, fluid overload, dysrhythmias (↑K )⁺
