Renal

Overview

Renal is a medical a general medical specialty, focusing on the management of kidneys. The kidneys are responsible for maintaining fluid balance

Physiology

Structures

• Urinary tract Anatomy & Function

• Kidney Anatomy

• Nephron Anatomy: glomerulus, convuluted tubules and loop of Henle

Functions

• Blood filtration & production of urine

• Homeostasis of water, salts (Na, K, Ca, Mg, P03) and blood pressure

• RAAS: renin, angiotensinogen, aldosterone system

• EPO and Haemoglobin production

Diseases

AKI (Acute Kidney Injury) & CKD (Chronic Kidney Disease) 

Glomerulonephritis

• Nephrotic Syndrome (primary, 4)

  • Diabetic Nephropathy 

  • Membranous Nephropathy 

  • Minimal Change Disease 

  • Focal Segmental Glomerulosclerosis (FSGS)

  • Secondary- Amyloidosis , Membranous Lupus Nephritis , HIV 

• Nephritic Syndrome

  • IgA Nephropathy 

  • Poststreptococcal Glomerulonephritis 

  • Crescent or rapidly progressive glomerulonephritis (RPGN):

    • • Goodpasture's Disease 

      • IgA Nephropathy , HSP 

      • Systemic Lupus Erythematous 

Tubulopathies

• Acute Tubular Necrosis 

• Renal Tubular Acidosis 

• Renal Tubulopathies (Inherited) - alkalotic

Interstitial: 

• Acute Interstitial Nephritis & chronic interstitial nephritis

Homeostasis

• Hypertension (disease) 

• Salts

• • Na+: HypoNatraemia  & HyperNatraemia - Diabetes Insipidus 

  • K+: HypoKalaemia & HyperKalaemia

  • Ca2+: HypoCalcaemia & HyperCalcaemia - Osteoporosis & Renal osteodystrophy

  • Mg2+: HypoMagnasaemia & HyperMagnesaemia 

  • PO4/3-: HypoPhosphataemia & Hyperphosphatasemia 

• Hb & EPO

  • Anaemia & Polycythaemia 

Vascular

• Renal Artery Stenosis

• Renal Vein Thrombosis

Genetic

• Alport's Syndrome 

• Polycystic Kidney Disease 

Urology

• Urinary Tract Infections

• Urinary Stones 

Assorted Other

• Reflux Nephropathy 

• Cardio-renal syndrome, Hepato-renal syndrome

• End of Life Care 

Clinical

Presentations

• Urinary Symptoms 

  • Haematuria, proteinuria

  • Oliguria, anuria & polyuria

• Abdominal Pain 

Examination

• Renal Transplant Examination

• Fluid Review 

Investigations

• Creatinine & eGFR

• Salts

  • Na+: HypoNatraemia  & HyperNatraemia 

  • K+: HypoKalaemia & HyperKalaemia

  • Ca2+: HypoCalcaemia & HyperCalcaemia 

  • Mg2+: HypoMagnasaemia & HyperMagnesaemia 

  • PO4/3-: HypoPhosphataemia & Hyperphosphatasemia 

• Hb & EPO

  • Anaemia & Polycythaemia 

• Urine analysis

  • Urine dip

  • Urine microscopy

• Renal Biopsy

Management

• Lifestyle

  • Fluid, salt and protein intake

• Medical

  • Fluids and furosemide

  • Salt supplements

  • EPO

  • Antihypertensives and renal protective

  • DMARDs and steroids

  • Statins, blood thinners

• Interventions

  • Renal Replacement Therapy - dialysis & kidney transplants

Wider

Ethics

Allocating limited Renal Transplant resources

Resources and References

Written in 2025