| Glomerulonephritis Definition | Glomerulonephritis (GN) is a renal disease characterised by inflammation and damage to the glomeruli. |
| Nephrotic Syndrome Definition | The definition of nephrotic syndrome includes both massive proteinuria (≥3.5 g/day) and hypoalbuminaemia (serum albumin ≤30 g/L).
Increased permeability of the glomerulus leading to loss of proteins into the tubules. This leads to the loss of significant volumes of protein via the kidneys (proteinuria) which results in hypoalbuminaemia. |
| Symptoms of Nephrotic syndrome | Peripheral oedema (more common in adults)
Facial oedema (more common in children)
Frothiness of urine (proteinuria in urinalysis)
Fatigue
Poor appetite
Recurrent infections (due to immune dysfunction)
Venous or arterial thrombosis (e.g. myocardial infarction, deep vein thrombosis) due to hypercoagulability |
| Signs of Nephrotic syndrome | Oedema (e.g. peri-orbital, lower limb, ascites)
Xanthelasma and/or xanthoma
Leukonychia (white dots on nails)
Shortness of breath (with associated chest signs of pleural effusion – e.g. stony dullness in lung bases) |
| Nephritic Syndrome definition | Damage to the thin glomerular basement membrane with pores that allow protein and blood into the tubule. This involves
Haematuria / Red cell casts
Proteinuria - mild to moderate(typically less than 3.5g/L/day)
Hypertension (mild)
Oliguria
Uraemia |
| Nephritic syndrome symptoms | Haematuria (can be frank haematuria or microscopic)
In urinalysis red cell casts would be found, which is a distinguishing factor from nephrotic
Oedema (to a lesser extent compared to nephrotic syndrome)
Reduced urine output
Uraemic symptoms (e.g. reduced appetite, fatigue, pruritus, nausea) |
| Risk factors of Malignancy | Occupational
Environmental
Genetic
Age
Sex
Smoking
Alcohol
Obesity |
| Renal adenocarcinoma (RCC) Triad | Haematuria (may produce iron deficient anaemia 60%)
Flank pain (40%)
Flank mass (25%) |
| RCC treatment | Established – Surveillance – Radical nephrectomy – Partial nephrectomy Developmental – Ablation |
| What is Nephroblastoma (Wilms' Tumour) | Abnormality in chromosome 11 (children), leading to
Large abdominal mass, abdominal pain, anaemia, incidental finding, hypertension, haematuria, weight loss. |
| Most common bladder carcinoma | Transitional cell carcinoma (90%) |
| Signs and symptoms of Bladder carcinoma | Painless haematuria must be treated as urinary tract malignancy until proven otherwise
LUTS, loin/suprapubic/urethral/penile tip pain |
| Prostate cancer Grading | Grade Group 1 The cells look similar to normal prostate cells. The cancer is likely to grow very slowly, if at all. Grade Group 2 Most cells still look similar to normal prostate cells. The cancer is likely to grow slowly Grade Group 3 The cells look less like normal prostate cells. The cancer is likely to grow at a moderate rate Grade Group 4 Some cells look abnormal. The cancer might grow quickly or at a moderate rate Grade Group 5 The cells look very abnormal. The cancer is likely to grow quickly |
| Tests for Prostate cancer | PSA is a protein produced by normal and cancerous prostate cells. PSA is secreted by prostate epithelial cells into prostatic fluid, where its function is to liquefy semen and thus allow spermatozoa to move more freely.
Cancer can be present without increased PSA levels, and there are many other causes of increased PSA levels (for example, benign prostatic enlargement, prostatitis, and urinary tract infection).
Digital Rectal Examination
MRI
Biopsy |
